POLICY PRIORITIES: THE CHALLENGE:
ONE BIG BEAUTIFUL BILL ACT
The One Big Beautiful Bill Act represents the most significant restructuring
of Medicaid financing since the Affordable Care Act. For autism and ABA service providers — who serve hundreds of thousands of children through Medicaid — the implications are profound and immediate.
KEY CONCERNS
FOR AUTISM PROVIDERS
COVERAGE LOSSES:
The Congressional Budget Office projects
10-16 million Americans will lose health insurance by 2034 — with children's access to autism services
directly at risk as family eligibility changes
WORK REQUIREMENTS:
New 80-hour monthly work requirements for Medicaid eligibility will create significant administrative barriers and potential coverage disruptions for families of children with autism
STATE PAYMENT CAPS:
State-directed payment caps will create
unprecedented pressure on reimbursement rates
for autism services
PROVIDER TAX RESTRICTIONS:
New limitations on provider taxes will
fundamentally change how states finance Medicaid programs, potentially reducing funds available
for autism services
REDETERMINATION CYCLES:
6-month Medicaid redetermination cycles
beginning in 2027 will create constant eligibility churn, disrupting treatment continuity for children with autism
OUR ADVOCACY
PRIORITIES
Protecting Medicaid Access
We advocate for policies that maintain and strengthen Medicaid coverage for children with autism, including exemptions from work requirements for caregivers of children with disabilities, reasonable redetermination timelines, and protections against coverage gaps that disrupt treatment.
Fair Reimbursement Rates
Autism and ABA services require highly trained professionals and intensive therapy hours. We fight for reimbursement rates that reflect the true cost of delivering high-quality care, ensuring providers can maintain sustainable operations while serving Medicaid populations.
Network Adequacy Standards
Medicaid managed care organizations must maintain adequate provider networks to ensure timely access to autism services. We advocate for enforceable network adequacy standards that hold MCOs accountable for providing the access their members deserve.
Administrative Simplification
Excessive prior authorization requirements, documentation burdens, and administrative barriers delay care for children with autism. We push for streamlined processes that prioritize patient access over bureaucratic complexity.
State-Level Implementation
Federal legislation is implemented at the state level — and every state is different. We provide state-by-state advocacy support to ensure that implementation decisions protect autism services and the families who depend on them.