Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 1776
Brief Description: Requiring coverage for applied behavior analysis.
Sponsors: Representatives Senn, Callan, Macri, Taylor, Gregerson and Pollet.
Brief Summary of Bill
  • Requires health plans to cover applied behavior analysis therapy for the diagnostic category of intellectual disability, which includes intellectual disability, with a specification of severity; global developmental delay; and unspecified intellectual disability.
Hearing Date: 2/14/23
Staff: Ingrid Lewis (786-7293).
Background:

Applied Behavior Analysis.
Applied behavior analysis (ABA) is a systemic approach to the assessment and evaluation of behavior, and the application of interventions that alter behavior.  The "practice of applied behavior analysis" includes:

  • the design, implementation, and evaluation of instructional and environmental modifications based on scientific research, observation, measurement of behavior, and the environment to produce socially significant improvements in human behavior;
  • empirical identification of functional relations between behavior and environmental factors; and
  • utilization of contextual factors, motivation, stimuli, positive reinforcement, and other consequences to alter behavior.

 

Applied behavior analysis therapy is provided by licensed behavior analysts, licensed assistant behavior analysts, and certified behavior technicians. 

 

Essential Health Benefits Benchmark Plan. 
Passed in 2010, the federal Patient Protection and Affordable Care Act (ACA) enacted a variety of provisions related to private health insurance coverage, including establishing essential health benefits, out-of-pocket maximums, prohibiting annual or lifetime limits, and discrimination prohibitions. 

 

The ACA requires most individual and small group market health plans to cover 10 categories of essential health benefits.  To determine the specific services covered within each category, federal rules allow states to choose a benchmark plan and to supplement that plan to ensure it covers all 10 categories.  State law designates the largest small group plan in the state as the benchmark plan.  Consistent with federal law, the Insurance Commissioner must supplement the benchmark plan to ensure that all 10 categories of essential health benefits are included.
Summary of Bill:

Health plans issued or renewed on or after January 1, 2024, must provide coverage for ABA therapy for the diagnostic category of intellectual disability, which includes intellectual disability, with a specification of severity; global developmental delay; and unspecified intellectual disability.
Appropriation: None.
Fiscal Note: Requested on February 6, 2023.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.