Dozens of Indianapolitan parents and advocates, their faces etched with concern, gathered outside Governor Holcomb’s residence in August 2023, demanding the reconsideration of the recently proposed cuts to Medicaid reimbursements for Applied Behavior Analysis (ABA) therapy, a well-regarded treatment for children with autism.
For those unfamiliar, ABA is a lifeline for many families. It equips children with autism spectrum disorder (ASD) with life skills, helping them transition into independent, thriving adults.
Molly Dubovec, a parent of an eight-year-old who’s benefited from ABA, mentions how her son “learned things that [she] never thought he might be able to learn.” Such testimonials are not uncommon. Chelsie Young, another devoted parent, poignantly shared that without ABA, simple tasks like fetching her mail became a challenge, fearing her daughter might run outside without understanding the perils of the busy streets.
Amid these compelling stories, a looming shadow threatens to disrupt the continuity of ABA for many in Indiana. The Family and Social Services Administration (FSSA) is considering reducing Medicaid reimbursements for ABA from $91 to a meager $55 per hour. This proposition risks causing therapy centers to shut down and depriving children of the care they desperately need. To bring that to perspective, Roopam Harshawat, the CEO of Harsha Behavioral Clinic, mentions that the proposed reimbursement “falls way short of therapy providers’ expenses per hour.”
While one could argue from an administrative standpoint about budget constraints – after all, ABA therapy spending surged from $121 million in 2019 to $420 million in 2023 – there’s an inherent risk in adopting a purely transactional view of healthcare. State Rep. Craig Haggard, who has a stepson on the spectrum, aptly put it when he said ABA is “a life-changing therapy, not just a number on a spreadsheet.”
Healthcare trends ebb and flow, often influenced by policy decisions, budget allocations, and administrative changes. However, beneath these macro elements lie real stories of mothers like Young, who say, “ABA is not just for [her daughter] Lilly. They’re teaching me how to work with Lilly and how to be a parent to Lilly.”
We can see from Young’s story that ABA isn’t only skill development and social skills – it’s a support system for the entire family.
Regional nuances often play a significant role in understanding the broader picture when discussing healthcare. While the recent controversy surrounding ABA therapy in Indiana has caught national attention, it’s worth investigating how different states, like California, approach the availability of autism services like ABA.
Regarding innovative healthcare legislation, California has long been a leader. This is especially true for its policies surrounding ABA therapy. But how does the Golden State ensure its widespread availability and affordability?
With both private insurance and Medi-Cal providing coverage, many Californian families have better access to ABA than they might in states without such robust mandates. While California’s mandates ensure coverage, insurance models could work on their reimbursement policies. Some families might initially pay out-of-pocket and then get reimbursed by their insurance, which could pose short-term financial challenges.
Like in Indiana, families in California acknowledge the profound impact of ABA therapy. The structured, individualized interventions help many children develop essential life skills, from basic communication to more complex social interactions.
California’s approach to ABA therapy showcases a model where legislative action aligns with the genuine healthcare needs of the community. Experience the gold standard in care at Sacramento ABA Therapy. As healthcare trends evolve, our shared responsibility is to ensure that decisions, while fiscally sound, do not compromise on the fundamental right of individuals to access quality care.
