Parents of children with Autism Spectrum Disorder recently received notice from the Department of Health and Human Services that treatment would not be covered under the Affordable Care Act of 2010. The word "affordable" is laughable for many families, as the cost for ASD behavior treatment (Applied Behavior Analysis) may total $60,000 or more each year. While there are other therapies available, many regard ABA as an essential treatment for their child's condition. Supporters had lobbied that the "10 Essentials" would include the ABA treatment, and it was written into law by Congress, but by the time the President signed it, ABA was no longer included.
Each state will now determine what is covered by the term "behavioral health treatment." As many states are already operating in a deficit, it is unlikely that expensive treatments will be covered. It is more likely that pharmaceutical companies will benefit by an increase in prescriptions written to manage children with ASD. As many individuals receiving Medicare already know, determination of treatment is cost-based, not quality of life based. While a treatment may improve your life, Medicare will always choose the cheapest treatment option. If you want anything better, you have to pay for it yourself, a point that many people either missed or didn't believe was true when the health care debate was going on.
When you have to pass a bill to find out what is in it, is it any wonder that there were slights of hand? What people were promised at the beginning of the legislative process was not what was delivered at the end. There was an illusion of transparency, but in the end, families of disabled children were duped. Only the poorest of the poor, and not the middle class, will receive affordable assistance, which makes me wonder to what lengths people will go to in order for their children to receive treatment. There may well be a growing number of individuals on the welfare roles if parents are forced to choose between earning a living or helping their child the only way they can.
Click the link to read the final version of the Health Benefits Bulletin from the Department of Health and Human Services.