I have a friend in Houston whose daughter is autistic. In early May, a bill went through the Texas state legislature which mandated that insurers cover Applied Behavior Analysis (ABA) therapy for children ages 3-5. This therapy is apparently intensive (20-40 hours a week) and commensurately expensive, but incredibly successful: half of the autistic children who receive this therapy are able to function in normal schools with minimal or no support. This therapy has been recommended by the Surgeon General since 1987. Also, it makes long-term economic sense for the state becasue the autistic person doesn't need as many state services later in life - it saves an estimated $3 million over the person's life.

Texas State Rep Larry Taylor added an amendment to the bill that un-mandated ABA therapy coverage. This would mean that the therapy mostly wasn't going to happen, and autistic children who might have benefited would likely just end up wards of the state. (Taylor is famous for bills requiring elective courses for academic study of the Bible, and for providing state funding for "Choose Life" license plates.) He's a former insurance agent who's in the pocket of the insurance industry.

My friend has a widely-read blog. He posted this story along with detailed instructions for letter writing and calling the most relevant state congressmen to shepherding this bill along without the bad amendment. And, after a few weeks of heart-wrenching setbacks, it worked! The original bill died (amendment and all), but it reappeared as a House bill which languished in committee, looking like it wasn't going to go anywhere, but on the last day of the session (when the legislature doesn't normally conduct any new business like bringing new bills up for a vote) it miraculously came out of committee, was voted on, and passed! The governor has indicated that he'll sign it, so the ABA coverage mandate will become law.

Here is what my friend did to get this bill passed:
- he understood exactly which congressmen were responsible for what, and targeted his communication effort at them, instead of trying to get votes in general. For an unglamorous topic like this, a pretty small number of congressmen are interested in the bill, and it's them who cause it to succeed or fail, not the congress as a whole.
- he posted a blow-by-blow saga of the bill with updated instructions for how to help as it went through its various incarnations and adventures
- he had a lot of articulate, active friends. I wouldn't be surprised if a dozen people had composed and written letters.

But still, a dozen letters is well within the reach of most people with some political target.