Is Funding for Autism on the Holcomb Administration’s Medicaid Chopping Block?

Indiana is a national leader in autism care, providing lifechanging access to diagnostic and therapeutic care for children with Autism Spectrum Disorder (ASD). But families and providers are getting concerned that the Holcomb administration may soon cut Medicaid funding for ABA therapy – the most scientifically validated therapy for people with autism – as part of their plan to reduce Medicaid expenditures.
Could Rate Cuts Lead to Denial of Access?
ABA therapy is a lifeline for so many Hoosier families, especially for those families with limited means that rely on Medicaid to help pay for these services. A cut in the reimbursement rates could result in reduced access to quality ABA therapy, hitting the neediest first and spreading across Indiana. Parents are rightly concerned and have warned they’ll be forced to quit their jobs to provide full-time care to their children with ASD if access to ABA therapy is cut-off. The income loss could be permanent if their children can never re-enroll, regress in their behavioral challenges, and end up fully dependent on their families and adult assistance services for a lifetime.

“ABA therapy has changed both of my sons’ lives. I’m scared of what would happen if funding is taken away.”
– Rashaundra from Hammond, IN

‘Therapy Deserts’
Should the Holcomb administration move forward with cuts, we can expect to see ABA therapy providers close shop, a reduction in the number of therapists and parents facing the thought of long wait lists to get their child the help they desperately need. This approach to health policy will inevitably lead to ‘Therapy Deserts’ where entire communities throughout Indiana will have no access to ABA therapy. At the epicenter of these therapy deserts will be the neediest – low income and rural areas – where access to autism care is already a huge burden on families. U.S. Census data from 2021 shows that there were over 1.6 million children under the age of 18 in Indiana. Based on CDC data stating that 1 out of every 36 Hoosier children has ASD, the numbers would suggest that there could be at least 46,000 children with ASD in Indiana. It’s estimated that Indiana has upwards of 10,000 children who have been diagnosed with ASD but are not currently in treatment, and 20,000 still-undiagnosed children.[1]  Reducing the reimbursement rate will only make this situation worse. This is highly regressive approach to sound health policy and will undo years of progress that have been made by successive Indiana governors and legislators.

“It’s three hours of your day gone just from driving alone, and we did that for about eight months or so.”
– Jamie from Indianapolis, IN

Plunging Families into the Dark
The Holcomb administration is carrying out the reimbursement rate review process largely in the dark by using out-of-state consultants known to recommend deep cuts to services. This has led to growing concerns it is being done without considering those who would feel the largest impact: Hoosier families. No families who depend on ABA therapy have been consulted in the process. Instead, the efficacy of ABA therapy – a long-established therapy with decades of scientific validation – is being questioned to justify the cuts. That’s disingenuous. For many families impacted by autism, ABA therapy is the light at the end of the tunnel for their children, bringing the chance at a brighter future and a better quality of life. Cutting quality autism care will plunge them into the dark.

“Cutting coverage for ABA therapy would be devastating to my son’s future.”
– Amber from Elkhart, IN

[1] Based on analysis of Census DataBACB Data & CDC Estimates of Children Diagnosed with Autism.

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