According to the Legislative Budget Board (LBB), no significant fiscal implication to the State is anticipated from HB 813. The fiscal note assumes that any costs associated with implementing the bill could be absorbed using existing resources, meaning the LBB does not project a need for new state appropriations or a measurable negative impact to the state budget.

The fiscal note also states that no significant fiscal implication to units of local government is anticipated. In practical terms, the bill is not expected to impose material new costs on counties, cities, school districts, or other local governmental entities.

The agencies listed as sources include the Teacher Retirement System, Employees Retirement System, Texas Department of Insurance, Health and Human Services Commission, Texas A&M University System, and University of Texas System. The inclusion of those agencies suggests the LBB considered potential effects on state-administered or state-related health benefit programs, but concluded that any implementation costs would be absorbable.

Texas Policy Research recommends that lawmakers vote NO on HB 813. The bill seeks to expand required health benefit plan coverage for autism spectrum disorder treatment by updating the statutory definition of autism spectrum disorder, removing the requirement that a diagnosis be made before the child’s 10th birthday, and eliminating the existing statutory provision that allowed health plans to limit applied behavior analysis coverage for enrollees age 10 or older to $36,000 per year. The bill analysis further states that the bill expressly prohibits a health benefit plan from limiting coverage for applicable autism spectrum disorder services for any enrollee.

The bill does grow the scope of government, even though it does not create a new agency, office, program, or rulemaking grant. Its expansion is regulatory rather than bureaucratic. By broadening a state-mandated health insurance benefit and removing an existing statutory coverage limit, the bill increases the degree to which state law dictates the content of private health insurance contracts. That represents an expansion of government authority over private plan design, employer benefit decisions, insurer risk management, and consumer choice.

The bill does not appear to impose a significant direct burden on taxpayers. The LBB found that no significant fiscal implication to the state is anticipated, assumed any state costs could be absorbed using existing resources, and anticipated no significant fiscal implication to local governments. However, the absence of a high state fiscal cost does not mean the bill is cost-free. The likely costs are shifted into the private insurance market, where they may be reflected in premiums, employer benefit costs, plan design changes, or reduced availability of lower-cost coverage options.

The bill does increase the regulatory burden on businesses, particularly insurers and employers that sponsor affected health benefit plans. It restricts how covered plans may structure autism treatment benefits and removes a statutory cost-control mechanism for applied behavior analysis coverage. The bill analysis states that the measure would prohibit a health benefit plan from limiting coverage for applicable autism spectrum disorder services for any enrollee, which is a substantial limitation on private benefit design.

The bill does not impose a conventional regulatory burden on individuals in the form of licensing, reporting, penalties, or personal mandates. Its burden on individuals is indirect. Policyholders and employees may face higher premiums or fewer plan choices if insurers and employers respond to the expanded mandate by adjusting coverage or costs. Individuals who need autism treatment coverage may benefit from the bill, but the cost is spread across other policyholders through a compulsory coverage model rather than voluntary purchase or market competition.

For a limited-government analysis, the central issue is not whether autism treatment is valuable. The issue is whether the state should compel private health plans to cover a broader category of services without a clear limiting principle, cost cap, sunset, or market-based alternative. House Bill 813 expands government control over private insurance, increases regulatory obligations on businesses, and shifts costs through the private market while avoiding direct fiscal accountability in the state budget.

For these reasons, HB 813 conflicts with free enterprise and limited government principles. A more liberty-oriented approach would preserve consumer choice by allowing optional coverage riders, encouraging plan transparency, or reducing barriers to more varied insurance products rather than imposing a broader statutory benefit mandate.

• SB 562 (Same As)