The Changing Landscape of Autism Therapy Funding
Aubreigh Osborne, a bright 3-year-old, has recently made her first best friend at preschool—a milestone her mother, Gaile, once feared would never happen. Diagnosed with autism at just 14 months, Aubreigh faced many challenges, especially in social situations. Her journey took a positive turn when she began applied behavior analysis (ABA) therapy over the summer. This type of therapy aims to improve social skills and communication, and it has been life-changing for Aubreigh.
Just months ago, Aubreigh struggled with outbursts and self-harm. However, with the help of a trained technician who visits their home five days a week, she has made significant progress. This therapy has helped her connect with other children, eat more consistently, and even succeed in toilet training. “That’s what ABA provides us: moments of normalcy,” Gaile shared.
However, their joy was short-lived. In October, Aubreigh’s weekly therapy hours were cut from 30 to 15 due to state budget cuts in North Carolina. This reduction is part of a larger trend; many states are slashing Medicaid spending on autism therapies.
For example, Medicaid payments for ABA therapy in North Carolina are projected to rise dramatically, from $122 million in fiscal year 2022 to an anticipated $639 million by fiscal 2026—a staggering 423% increase. Other states have seen even steeper increases, like Nebraska, which recorded a jaw-dropping 1,700% rise in the same period.
In recent years, there’s been a surge in autism diagnoses, leading more families to seek therapy for their children. Mariel Fernandez from the Council of Autism Service Providers explains that the treatment often requires anywhere from 30 to 40 hours of direct therapy each week. The increased demand has led to pressures on state budgets.
The federal government has mandated that states cover autism treatments since 2014. Yet, not all states included ABA therapy until recently, despite it being considered the “gold standard” for autism treatment.
Parents are now scrambling as Medicaid cuts threaten access to these essential services. Families in North Carolina have even filed lawsuits against their state for implementing cuts. In Nebraska, drastic rate reductions have led providers to consider withdrawing from the Medicaid program altogether, which could directly impact the children who need these services most.
Gaile Osborne, who is also an advocate for foster care, reflects on her daughter’s journey. “It’s not perfect, but the growth is just unreal,” she says. Her persistence was pivotal in securing Aubreigh’s therapy slots back after the cuts.
The situation highlights a broader concern among families who rely on these services. Advocates worry that reductions could shift access away from those who need it most and lead to providers exiting the market. This fear is echoed by parents like Cathy Martinez in Nebraska, who went bankrupt trying to secure necessary treatments for her son. “No family should have to choose between bankruptcy and helping their child,” she stated passionately.
As state officials attempt to cut costs amidst rising expenditures, the ongoing struggles between budget constraints and the pressing need for autism therapy underscore a troubling dilemma. With various states considering similar cuts, the fight for robust therapy access continues, as families join together to demand better support for their children.
For families like Aubreigh’s, the stakes couldn’t be higher. The outcome of these funding issues will largely determine not just the availability of therapy, but the quality of life for countless children on the autism spectrum.
