03/14/2026
Really important things to note regarding the effects of limiting access to medically necessary treatment for autism:
- ABA (applied behavior analysis) therapy is the ONLY evidence-based medical treatment for autism spectrum disorder that is covered by insurance.
-If an autistic child is NOT receiving ABA therapy, their only options are residential placement (if their family can afford it), remaining at home where (most likely) a parent would have to become their full-time caregiver, or go to public school.
-If a child is successful academically but falls behind in self-regulation, social skills, or other aspects, the schools will likely not provide an IEP (individualized education plan).
-If a child is engaging in dangerous, inappropriate, or otherwise unmanageable problem behaviors, the school will call the parent and send them home.
I can go on for hours.
The parents will be unable to hold a job.
The kids will be denied the opportunity to function as "neurotypically" as possible.
The schools will be overwhelmed with students they are not prepared to support.
Right now, Medicaid is pushing for caps on treatment hours, denying therapy services after the age of 21, a requirement of 18 hours of parent training per 6-month period, among the many other requirements they have added over the past 2 years.
Families and providers both have to jump through hoops in order to obtain authorization for services at this point.
Changes certainly need to be made, but not at the cost of those fighting for the autism community, providing ethical services, and billing at normal rates.
Every single individual I have been privileged to provide services for has totally individual needs. Their rate of acquisition of new skills is different in every single case. Their behavioral needs are different in every single case. The way each child communicates. The way each child shows joy. The way each child interacts with others.
You cannot pinpoint a specific amount of ABA hours an individual would need before services are no longer effective or necessary. It is different in every single case.
What should be taken into consideration when approving or denying services should only relate to the treatment goals and the progress. Discharge goals exist for a reason.
For me and (probably/hopefully) most ABA professionals, we aren't in this for the money. I'm in it for the first time a child communicates spontaneously. I'm in it for the first time a child takes a breath and sits down in a frustrating moment instead of hurting themself. I'm in it for the child that most people don't understand.
I will always fight for them.
-Just a BCBA
