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Calls to Action

Insurers Get Pressure to Cover ABA for Federal Employees

May 06, 2013

WASHINGTON, DC (May 6, 2013) -- The agency in charge of managing health benefits for the nation's 8.2 million federal employees, retirees and dependents is urging its participating health plans to start covering ABA in 2014 or explain why they are refusing coverage.

The Office of Personnel Management (OPM) last year recommended for the first time that health plans participating in the Federal Employees Health Benefits (FEHB) program include coverage for applied behavior analysis (ABA). But of the 230 participating plans around the nation, only 67 offered the benefit for 2013 and many areas with large concentrations of federal employees, such as the National Capital Region, lacked coverage.

The coverage is significant as federal employees represent the largest single workforce in the United States. In March, a bipartisan coalition of 11 Members of Congress from Virginia, Maryland and the District of Columbia urged OPM to demand better coverage from FEHB's participating health plans.  

As the health plans now start developing their 2014 coverage, OPM has issued guidance that “encourage[s] plans to offer Applied Behavior Analysis (ABA) for children with autism,” and requires them to complete an online survey. The survey asks insurers that cover ABA in one of the 32 states that has enacted autism insurance reform whether they cover ABA for FEHB members and, if they do not, in what year they plan to do so.

For insurers that operate in Virginia, Colorado, Connecticut, New Jersey, or South Carolina, states that require ABA coverage, have significant numbers of ABA providers, and large populations of federal workers, the survey goes a step further – it asks plans that do not offer ABA to explain their decision.

"We are encouraged by this action by OPM and will continue working with our champions in Congress to make sure this coverage is the best possible," said Stuart Spielman, Autism Speaks' senior policy advisor and counsel. "Our goal is to provide autism insurance coverage for every family regardless of their health plan or where they live. Strengthening coverage for the nation's largest workforce is an important part of that effort. FEHB plans in all 50 states and the District of Columbia should provide the comprehensive care that children with autism need. OPM must leave no families behind."