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New Health Care Act Won't Cover Autism Therapy

Hat tip to the Disability Scoop blog, which wrote recently that the Affordable Care Act will not cover the intensive autism therapy called applied behavioral analysis, despite a "heavy lobbying effort:"

Under the federal law, most health insurance plans will be required to cover 10 so-called "essential health benefits" starting next year, one of which is "mental health and substance use disorder services, including behavioral health treatment."

Autism advocates urged regulators to include a requirement that applied behavioral analysis, or ABA therapy, be covered in rules governing what exactly qualified as a "behavioral health treatment," but a final rule issued this week makes no mention of the treatment.

(Here's a link to the final rule, all 143 pages of it.)

Applied behavioral analysis rewards children with autism for repeating wanted behaviors, while ignoring harmful or unwanted behaviors. It often involves hours of one-on-one interaction in structured settings. Whether ABA is covered by a policy will now be a matter of state, rather than federal policy. The National Council of State Legislatures maintains a list of the states, currently 37 plus the District of Columbia, that mandate some type of insurance coverage for autism.

However, whether that mandate specifically requires behavior therapy under the Affordable Care Act remains unclear, according to the advocacy group Autism Speaks.

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