2/1/2025
Indiana Medicaid proposed to cut ABA therapy April 1st, 2025, for children living with autism. We urgently need your help! This does not allow parents or providers much time to transition with limited services across the State of Indiana.
Indiana’s Office of Medicaid Policy and Planning (OMPP) has proposed limiting ABA coverage to 30 hours per week and a three-year lifetime cap on ABA coverage (with some exceptions) on APRIL 1, 2025. Unfortunately, no comments on what “exemptions” may be available.
Medicaid Spending on ABA needs more transparency.
According to an article from WISH TV News:
“As of Dec. 2024, about 7,300 Indiana Medicaid members receive ABA services. Indiana’s ABA expenditures, which officials say are among the highest in the country, are expected to reach $650 million by 2026”
In 2021, Medicaid spent $276 million on ABA services. Without established rates for services, Medicaid paid a percentage of what providers billed. Some providers and private equity groups charged our state exorbitant fees of up to $900+ an hour, leading Indiana to spend $638 million in 2023. By establishing a fee schedule for ABA in 2024, Indiana reduced its costs to $398 million. Despite the decrease of $240 million in one year, OMPP is coming after our children again. With this downward spending trend, why are OMPP and Governor Braun looking here to make further cuts? Especially when Indiana’s fee for ABA direct care is now average when compared nationally:
On the table, ABA is further limited to a lifetime maximum of three years, with a maximum of 30 hours per week. This budgetary decision significantly burdens schools and parents, who may struggle to compensate for the lack of medically necessary support. As a community, we must advocate for policies prioritizing our children’s well-being over further cost-cutting measures.
State Rep. Becky Cash (R) from Zionsville is introduced House Bill 1414 to hold off changes to ABA coverage until a study can be conducted and reviewed. This is a sensible step forward that will protect our children, families, providers, and schools in Indiana.
For families navigating the complexities of raising a child with autism, the recent news about Medicaid’s proposed cuts to Applied Behavior Analysis (ABA) benefits is both alarming and disheartening. For many families, ABA therapy is not just a treatment; it’s a lifeline offering hope for our children’s future. The potential reduction in coverage time and hours threatens to undermine the progress children in Indiana can make, leaving most families on Medicaid without services on April 1st to wonder how to bridge the gap between their child’s needs and the minimal support available in our state.
Understanding Autism and Developmental Challenges
Autism Spectrum Disorder (ASD) affects individuals in myriad ways, presenting unique developmental challenges that require tailored interventions. Beginning in early childhood, children with autism may struggle with communication, social interaction, and repetitive behaviors. Yes, these developmental hurdles can significantly impact a child’s ability to achieve significant milestones, such as forming friendships, excelling in school, and developing independence.
For families, behavior and developmental challenges extend beyond the immediate need for support. The journey through adolescence and into adulthood can be fraught with difficulties that require assistance that Indiana schools are not able or prepared to provide.
Teens with autism may face difficulties in transitioning to higher education or the workforce, and adults often require ongoing support for successful integration into society.
Each stage of life brings its own set of challenges, underscoring the need for consistent and comprehensive interventions like ABA therapy to be based on individual medical necessity, not simply years in treatment.
ABA therapy has been a cornerstone in the treatment and support of individuals with autism. Focusing on positive reinforcement helps children develop essential skills that improve their quality of life. The therapy is highly individualized, addressing specific needs and fostering gradual improvement over time. Professional therapists work closely with families to set realistic goals, monitor progress, and adjust plans as needed.
However, the effectiveness of ABA heavily relies on the therapy’s time and consistency. Limiting treatment based on arbitrary time frames or age rather than the child’s individual needs can hinder their development and long-term success. Decision-makers must recognize that each child’s journey is unique, and medically necessary support cannot be reasonably determined by a one-size-fits-all approach.
Together, we can work towards a future where all children receive the support they need to thrive.
Contact Your Legislators
To voice your concerns and advocate for the needs of children with autism, please reach out to your local legislators in Delaware County, Indiana:
– Senator Scott Alexander
– Phone: 1-800-382-8467
– Email: senator.alexander@iga.in.gov
– Representative Sue Errington
– Phone: 1-800-382-9842
– Email: h34@iga.in.gov
Please show State Rep. Becky Cash (R) from Zionsville, Indiana, your support as she advocates for Indiana children through HB 1414.
Written comments on the new policy will be accepted through Feb. 14.
Comments can be emailed to spacomment@fssa.in.gov
the subject line, “COMMENT RE: ABA THERAPY COVERAGE” or sent by mail to:
FSSA, Office of Medicaid Policy and Planning Attention: Madison May-Gruthusen
402 West Washington Street
Room W382, P.O. Box 7083