News Summary
In Massachusetts, advocates and parents are calling on state lawmakers to extend MassHealth coverage for applied behavioral analysis (ABA) therapy to adults over 21 with developmental disabilities or autism. A proposed amendment aims to address the gap in care for young adults transitioning out of pediatric services. Currently, ABA therapy is covered for children under 21, but funding cuts could threaten essential services. Advocates stress the need for continuous support, emphasizing that investing in appropriate care can lead to long-term benefits for individuals and society.
Boston, Massachusetts — Advocates and parents are urging state lawmakers to extend MassHealth coverage for applied behavioral analysis (ABA) therapy to adults aged 21 and older who have developmental or intellectual disabilities, or are on the autism spectrum. A proposed legislative amendment, identified as H 1351 / S 871, aims to mandate that MassHealth include ABA therapy for this age group, addressing a significant gap in care faced by many individuals as they transition into adulthood.
Currently, MassHealth provides ABA therapy for children under 21 years old but ceases coverage once individuals reach their 21st birthday. This abrupt cut-off has raised concerns among parents and advocates about a “cliff” in essential care services for young adults with autism and other related conditions. The importance of MassHealth is underscored by the fact that it serves nearly half of all Massachusetts children under 18, providing crucial health services, including medical treatments and therapies for conditions such as autism and epilepsy.
Amidst fears of potential financial cuts to Medicaid by Congress, which could severely impact services for families reliant on MassHealth, advocates are emphasizing the need for action. Medicaid constitutes a major part of MassHealth’s $20 billion budget, with federal sources contributing over half of that funding. Advocates caution that significant federal cuts to Medicaid would jeopardize care for vulnerable populations, including children and adults with autism. Analysts at the Massachusetts Medicaid Policy Institute emphasize that funding reductions could lead to dire consequences for services tailored to the health needs of children and young adults.
Recent data indicates that approximately 363,000 individuals were removed from MassHealth membership during a recent eligibility review, which included nearly 59,000 children. Under the current MassHealth regulations, children are eligible to receive ABA therapy until they turn 21, but lose access to critical interventions when transitioning to adult services, a situation that advocates argue is inherently discriminatory. They point out that it would not be acceptable for other medical treatments to be cut off arbitrarily at a specific age.
Massachusetts Governor Maura Healey and state healthcare officials have reiterated the need to protect funding for pediatric and adult care programs against the backdrop of federal uncertainties. This advocacy comes at a time when a settlement of over $2.5 million was reached with ABA service providers who were accused of submitting fraudulent claims to MassHealth. An investigation by the attorney general’s office revealed instances where some providers billed for services that were either not provided or inadequately supervised by licensed professionals.
In light of these challenges, advocates like Maura Sullivan from The Arc of Massachusetts have stressed the importance of collaborative strategies for cost containment in ABA access. They highlight that investing in appropriate services for individuals with autism can yield long-term benefits, not only for the individuals themselves but also for society as a whole. Advocates continue to push for legislative changes that would ensure individuals over the age of 21 can receive the necessary support and therapy services they need to lead fulfilling lives.
The push for extended MassHealth coverage of ABA therapy for adults comes amid ongoing discussions about the future of healthcare funding in Massachusetts and beyond. With financial pressures from federal authorities and the consistently growing need for services among individuals with disabilities, the outcome of the proposed legislative amendment could significantly impact the quality of care and support available to these individuals in the years to come.
Deeper Dive: News & Info About This Topic
HERE Resources
Additional Resources
- Boston Globe: Medicaid and MassHealth for Children
- Wikipedia: Medicaid
- CBS News: Medicaid Cuts Impacting Families
- Google Search: MassHealth Autism Services
- Boston 25 News: Autism Service Providers Fraud
- Google Scholar: ABA Therapy for Adults with Autism
- State House News: Coverage Loss for Individuals with Autism
- Encyclopedia Britannica: Applied Behavior Analysis
- Hoodline: Autism Service Provider Fraud
- Google News: Massachusetts Healthcare Legislation
