JENNA BURKHARD: Pay now or pay more later: ensuring Hamilton County families have Medicaid coverage for ABA therapy

In a few weeks, our state legislators will convene for the 2023 legislative session.

One issue that will likely be top-of-mind is Indiana’s high healthcare costs, which are creating a heavy burden on Hoosiers in Hamilton County who are already feeling the pain in their pocketbooks from high inflation.

The emphasis on high healthcare costs has spurred a flurry of proposals for lowering costs – including cutting the state’s spending on essential programs like Medicare and Medicaid. Policymakers must consider these proposals carefully and focus on adopting precise cost-cutting strategies instead of across-the-board cuts which could have unintended consequences and raise our healthcare costs in the long run.

A prime example of shortsighted cuts would be lowering coverage for preventative care. Cutting back on these types of care would ultimately lead to worse health outcomes and a much higher price tag down the road.

As an ABA therapist, I work daily to support and advocate for individuals with intellectual disabilities and their families – including individuals with Autism Spectrum Disorder (ASD). One of the most scientifically validated therapies for individuals with autism is called Applied Behavior Analysis (ABA) therapy. ABA therapy is a prime example of a routine intervention that can far improve outcomes in the long run.

Importantly, ABA therapy is far more effective as an early intervention. Participating in ABA therapy at an early age has lifelong impacts on people with ASD and their families – allowing them to be more independent, make their own income, and have a more robust social life. Simply put, early investment in ABA therapy pays off in the long run.

That’s why it is surprising that ABA may be singled out as a place to cut Medicaid coverage.

One of the main goals of ABA therapy is to limit the duration of service and prepare clients to leave the therapy setting and be able to translate their learned skills to the real world. That means most individuals with ASD receive this therapy for one or two years – and receive a lifetime of benefits, both for themselves and for their families who can now more reliably enter the workforce instead of 24/7 childcare at home.

Compare that to an entire adulthood of lost opportunities for individuals and their families if access to this care is stripped away. According to one study, services for adults with autism have a much higher cost than services for children, by a factor of three, costing as much as $196 billion a year, compared to $61 billion for children services.

Indiana has a reputation for providing superior autism services for those who need it while remaining fiscally responsible. That’s why state legislators and other decision-makers in Indiana should reject any Medicaid cuts for preventative autism care.

Drastic cuts would immediately impact families in Hamilton County and across the state coping with autism who rely on this care and would particularly burden low-income families who often need care the most. Just as important, a reduction in coverage today would be fiscally shortsighted, ignoring the future costs that are inevitable when children who lost access to services are increasingly dependent on the state.

Hoosiers deserve quality and accessible autism services. Drastic reductions in Medicaid reimbursement for ABA therapy will cost taxpayers more while hurting families.

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