The Affordable Care Act was signed into law on March 23, 2010. The health reform law has affected millions of Americans, including the autism community, and introduced new provisions that affected the availability, adequacy, and affordability of health care including Health Insurance Marketplace Exchanges. Depending on where you live, the coverage options on the Health Insurance Marketplace will differ. To help you better understand your options try the tools below or review the Autism Speaks resources on how the Affordable Care Act impacts individuals with autism and their families.
The Marketplace is an online portal accessible at www.healthcare.gov that helps people find and enroll in a health insurance plan. All plans sold on the Marketplace must comply with certain federal guidelines, including provision of the Essential Health Benefits for that State. You can purchase a Health Insurance Marketplace plan only from the State in which you permanently reside. Some states have established their own state-based Marketplace while others utilize either a State-partnership or Federally-facilitated Marketplace.
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Nearly 8 in 10 of the approximately 10.5 million uninsured individuals likely to be eligible for qualified health plans may be eligible for tax credits through the Marketplaces. Other families with autism may also be eligible for the Children’s Health Insurance Program (CHIP) or Medicaid.
Many families with autism may want to know if Applied Behavior Analysis (ABA) is covered on plans purchased on the Marketplace. In fact, ABA is an Essential Health Benefit and required to be covered in Marketplace plans, as well as in all new individual plans sold outside the Marketplace, in the following 29 States plus the District of Columbia: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Texas, Vermont, Washington, West Virginia and Wisconsin. Learn more about ABA coverage on the marketplace here.
Autism Speaks remains dedicated to advocating for meaningful health insurance coverage for all individuals with autism regardless of where they live. To get involved with further reforms, sign up here and be sure to follow us at @AutismVotes.