Senate panel narrows ABA coverage in SB2190 to people with autism; amendment and bill pass committee

The Senate Human Services Committee on an amendment limited proposed Medicaid coverage of applied behavior analysis to “individuals with autism spectrum disorder,” and then voted to pass Senate Bill 2190 as amended.

The amendment replaced broader language covering ‘‘a variety of psychological and medical diagnoses’’ with a narrower definition, directing that ABA be covered “across the lifespan of individuals with autism spectrum disorder.” The committee adopted that change on a 5–1 roll call and later moved SB2190 out of committee as "due pass as amended," also on a 5–1 vote.

Why it matters: supporters said narrowing the covered population would reduce the bill’s fiscal impact while retaining ABA services for people on the autism spectrum. Sarah Aker, executive director of the Division of Medical Services at the Department of Health and Human Services, told the committee that the narrower language would reduce the fiscal note. Aker summarized the amended text as providing ABA “to provide coverage to both assess and treat common behavioral problems across the lifespan of individuals with autism spectrum disorder.”

Committee discussion and fiscal estimates focused on scale. Aker gave the approximate fiscal estimate tied to the narrower amendment as “approximately 860, thousand dollars.” Committee members contrasted that with an estimate for the broader language — Aker described that number in committee discussion as “about 13,000,000.” Senators voiced differing views on scope: one member said they preferred a narrower start focused on autism spectrum disorder, while another said they were concerned the amendment did not go far enough.

Committee members also discussed how this change interacts with Medicaid expansion and with plans for a cross‑disability waiver. Aker said the bill does not change dental coverage and that the Medicaid expansion population referenced in another subsection is currently covered, so no change was needed there. Committee members asked whether behavioral‑health services for other diagnoses could be addressed in a cross‑disability waiver; Aker said behavioral health is not a recommended qualifying condition for the children's waiver today but that the cross‑disability waiver might create a pathway for children with severe behavioral‑health needs.

Votes at a glance: the amendment replacing broader diagnostic language with “autism spectrum disorder across the lifespan” passed 5–1 (Yeas: Senator Lee, Senator Rohrs, Senator Hogan, Senator Van Osteen, Senator Clement; Nay: Senator Weston). The committee later approved due pass as amended by a 5–1 vote (Yeas and Nay as recorded during roll call).

Next steps: committee members requested a revised fiscal note after the amendment. The bill will move forward from committee as referred.