Key Takeaways
- Applied behavior analysis (ABA) therapy has been shown to be effective in improving social interactions and communication in individuals with autism.
- Many states are cutting Medicaid spending on ABA therapy due to budget shortfalls and concerns about improper payments.
- Families and advocates are fighting back against these cuts, citing the importance of the therapy for individuals with autism.
- The federal government ordered states to cover autism treatments in 2014, but not all states covered ABA until 2022.
- The treatment is intensive and comprehensive, and can include 30-40 hours of direct treatment per week.
Introduction to ABA Therapy
Applied behavior analysis (ABA) therapy has been a game-changer for many families with children diagnosed with autism. For Gaile Osborne and her adoptive daughter Aubreigh, ABA therapy has brought about significant improvements in social interactions and communication. Aubreigh, who was diagnosed with autism at 14 months old, started ABA therapy at the age of 3 and has since made tremendous progress. She has started preschool, begun eating more consistently, succeeded at toilet training, and even made a best friend. According to Osborne, ABA therapy has given her family "moments of normalcy," which they never thought possible.
The Challenges of Accessing ABA Therapy
Despite its effectiveness, accessing ABA therapy can be challenging, especially for families who rely on Medicaid. Many states are struggling to balance their budgets, and Medicaid spending on ABA therapy has become a target for cuts. In North Carolina, for example, the state attempted to cut payments to ABA providers by 10%, which would have reduced Aubreigh’s weekly therapy hours from 30 to 15. Similarly, in Nebraska, payment cuts of up to 50% for some ABA providers have been implemented, prompting concerns about access to the therapy. These cuts are not unique to these states, as many other states, including Colorado and Indiana, are also considering reductions in Medicaid spending on ABA therapy.
The Impact of Cuts on Families
The impact of these cuts on families is significant. For Danielle Westman, whose 15-year-old son Caleb receives 10 hours of at-home ABA services a week, the thought of losing access to the therapy is devastating. Caleb has limited use of language and a history of wandering away from caregivers, and Westman credits ABA therapy with helping him manage his anxiety and behaviors. She is relieved that her provider, Above and Beyond Therapy, has reversed its decision to stop participating in Nebraska’s Medicaid program, but she remains concerned about the long-term sustainability of the therapy. Many other families are also fighting back against the cuts, with some filing lawsuits and advocating for their children’s right to access the therapy.
The Role of Medicaid in Funding ABA Therapy
Medicaid plays a critical role in funding ABA therapy for many families. The federal government ordered states to cover autism treatments in 2014, but not all states covered ABA until 2022. As a result, many families have only recently gained access to the therapy, and they are now facing the threat of cuts. According to Mariel Fernandez, vice president of government affairs at the Council of Autism Service Providers, the treatment is intensive and comprehensive, and can include 30-40 hours of direct treatment per week. The cost of the therapy can be significant, with some families paying upwards of $60,000 per year out-of-pocket. Medicaid has helped to make the therapy more accessible, but the cuts to Medicaid spending on ABA therapy are now putting that access at risk.
The Debate Over ABA Therapy
Not everyone agrees that ABA therapy is the best approach for individuals with autism. Some critics argue that the therapy is overly focused on changing the individual’s behavior, rather than accepting and supporting them as they are. Others argue that the therapy is not effective for all individuals with autism, and that other approaches, such as occupational therapy or speech therapy, may be more beneficial. However, for many families, ABA therapy has been a lifeline, providing them with the tools and support they need to help their children thrive. As Gaile Osborne notes, "It’s not perfect, but the growth in under a year is just unreal." The debate over ABA therapy highlights the need for more research and funding to support individuals with autism and their families.
Conclusion
The cuts to Medicaid spending on ABA therapy are a concern for many families who rely on the therapy to support their children with autism. While some states are implementing cuts due to budget shortfalls and concerns about improper payments, families and advocates are fighting back, citing the importance of the therapy for individuals with autism. As the debate over ABA therapy continues, it is essential to prioritize the needs of individuals with autism and their families, and to ensure that they have access to the therapies and supports they need to thrive. By working together, we can create a more inclusive and supportive environment for individuals with autism, and help them reach their full potential.
