Medicaid coverage for Applied Behavior Analysis (ABA)
I recently read a quote from a parent of a child with autism: “The hardest part about autism is knowing what treatments and therapies your child could benefit from, and not having the financial resources to get him the help.” (autismspeaks.org) For many parents, this is a heartbreaking reality. For families living in the state of Texas, this is even more challenging.
Currently, Texas denies Medicaid coverage for Applied Behavior Analysis (ABA), an evidence-based, behavioral therapy that has proven effective in treating the behavioral symptoms of autism. In 2014, federal guidance from the Centers for Medicare & Medicaid Services (CMS) advised states that they should cover medically necessary care for Medicaid-eligible children diagnosed with autism through the age of 21. These services include ABA, as well as speech, occupational, and physical therapy. Although other states quickly adopted this policy (e.g., California, Virginia), others required legal prodding (e.g., Florida), and still Texas maintains its stronghold in denying coverage.
Much of the controversy involves a complicated debate regarding licensure versus certification of ABA therapists. What is not up for debate is the profound benefit of early behavioral interventions for children with autism. Research has shown that early, play-based ABA can improve positive outcomes for cognitive abilities, communication, and social interaction skills (Rogers & Dawson, 2009). In addition, research suggests that the state of Texas would save over 2 billion dollars if funds were allocated to early intervention, rather than 18 years of special education costs through school (Chasson, Harris, & Neely, 2007).
It is important for parents to remain well informed about the policies in place that affect access to care. For a list of helpful organizations and websites to remain connected to the latest in autism news, please visit: https://www.abaconnect.com/autism-resources/websites/
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