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The ACA, Autism and 'Habilitative' Care

January 14, 2014

WASHINGTON, DC (January 14, 2014) -- With the rollout of the Affordable Care Act (ACA) now well underway, Kaiser Health News (KHN) has found many families caring for children with disabilities, including autism, struggling to gain coverage for therapies such as Applied Behavior Analysis (ABA).

The KHN report quotes Sara Rosenbaum, a George Washington University professor who has studied the ACA's habilitative coverage requirements, as finding that insurers do not believe such treatments are medically necessary. “They’d say patients are not recovering function, but rather developing function, and that was an education issue,” Rosenbaum told KHN.

Lorri Unumb, Autism Speaks' vice president for state government affairs, explained that 34 states have required some level of coverage for ABA and other habilitative services for autism in their state-regulated plans. But fewer than half the states have clearly defined habilitative services coverage through their implementation of the ACA, said Katie Keith, a former Georgetown University professor consulting for Autism Speaks.

To learn more about the ACA and Autism, go here.