Autism Speaks | ‘The ACA’s 50-State “Essential Health Benefits” Tangle:’ LDI Health Economist | June 30, 2012 #AutisticHistory #BanABA


[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]

‘The ACA’s 50-State “Essential Health Benefits” Tangle:’ LDI Health Economist

June 30, 2012

PHILADELPHIA (June 30, 2012) — Janet Weiner, MPH, associate director for health policy at the University of Pennsylvania’s Leonard Davis Institute of Health Economics, assesses how the states are implementing the Affordable Care Act and incorporating autism coverage as part of the required essential health benefits package.

The ACA’s 50-State ‘Essential Health Benefits’ Tangle

Autism Advocates Wary of Losing Hard-Won Coverage

Janet Weiner, June 2012

PHILADELPHIA — The federal government’s efforts to implement national healthcare reform are being greatly complicated by a legacy of state-based insurance regulation. The battles to define exactly what medical conditions, procedures or services insurance companies must cover — the “essential benefits” have long been matters of the statehouse politics that created more than 1,600 different laws 

Alternative contentAutism researcher and University of Pennsylvania psychiatry and pediatrics professor David Mandell notes insurers’ reluctance to cover certain essential benefits related to autism.across the country. For instance, Iowa has 17 essential benefits mandates; Rhode Island has 70. Some legislatures require the coverage of services like in-vitro fertilization, chiropractic care and behavioral therapies for autism and some do not.

Widespread uncertainty
Some of this variability will remain untouched in the first two years of implementing the Affordable Care Act’s essential health benefit package. The end result will be a patchwork of differing offers and widespread uncertainties. Many interest groups are as confused as they are unhappy about this, particularly advocates of issues like autism who have waged protracted political battles to secure previously denied coverage.Assuming it is upheld by the Supreme Court, the ACA establishes broad categories of essential health benefits that must be included in policies sold to individuals or small groups. (Large employers and “grandfathered” plans will not be subject to essential health benefit mandates). The law left it up to the Secretary of Health & Human Services (HHS) to define the exact details of that benefits package. But she didn’t. Instead, in December 2011 Secretary Kathleen Sebelius announced an interim policy that allows each state to “benchmark” its own essential benefits package to one of several existing employer-based insurance plans.”We want to take advantage of plans that were in the market, were purchased, were priced, and could be up and running as we start this process,” Sebelius explained to Congress in February.

‘Violates Congress’ directive

That unexpected move spawned controversy. The National Association of Community Health Centers objected and said the action “violates Congress’ directive to the Secretary to establish essential health benefits, and also runs counter to Congress’ intent to create a uniform federal core of benefits to be offered by [qualified health plans].”The National Council of State Legislatures (NCSL) noted its satisfaction that Sebelius’ plan “provides options that will allow states to maintain their existing state mandated benefits without creating a budget liability in 2014 and 2015, providing states an opportunity to review their mandated benefits.”The bottom line is that by September, each state must select a benchmark plan for essential benefits offered to individuals and small groups in 2014 and 2015.The ACA does not directly preempt any of the existing local mandates, but it does require states to pay the costs of state-mandated benefits that are not included in the benefits package offered through the subsidized insurance exchanges.

Financial disincentives

This creates potential financial disincentives that have advocates scrambling to ensure that their existing mandated benefits are part of the new benchmark packages in their state. Conversely, legislators are worried that their state will be stuck with the cost of subsidizing these mandates when the HHS re-evaluates the interim essential benefits policy in 2016.At that point, HHS might follow the Institute of Medicine’s recommendation that “current state insurance mandates — requirements that had previously been established by state law — should not automatically be included in the EHB package but reviewed in the same way as other potential benefits.”One of the interest groups keeping a close watch on these developments is America’s autism advocates. In recent years, they’ve scored high-profile successes in 30 legislatures that have mandated coverage for behavioral therapies for autism, albeit with different frequency and monetary limits.

Reluctant insurance industry
Autism researcher and University of Pennsylvania psychiatry and pediatrics professor David Mandell pointed out that the insurance industry has been reluctant to voluntarily offer such coverage. Some providers, meanwhile, suggest that up to 25 hours a week of intensive behavioral therapy is needed and should be covered.”The thing that scares the insurance companies is the number of hours we’re talking about,” said Mandell. “There’s no defined end for the course of treatment. They want to know how we put some boundaries around this benefit?”With New Jersey having the highest rate of autism in the nation, Sen. Robert Menendez (D-NJ) is a well-known advocate for coverage of autism treatments. As a member of the Senate Finance Committee, he Watch a 2:42-minute video of Penn’s David Mandell discussing how insurance companies may ‘game’ the system to avoid certain types of autism coverage.pushed through an early amendment to the ACA to include behavioral health services as part of the ACA-defined essential health benefits package.

In a Congressional hearing in February, he noted the deficiencies of the current “patchwork” of state autism coverage mandates and exemptions. “I know I am not alone in the serious concerns that the benchmarking plan is insufficient to ensure that behavioral health coverage would be available as the law dictates it to be.”

Pennsylvania autism mandate

Mandell is a veteran of the battle to mandate autism coverage in Pennsylvania. In 2009, the state passed one of the most generous insurance mandates in the country, with a $36,000 cap per year on services for autistic individuals up to age 21, and no lifetime limit. He cited two possible changes to autism mandates based on the ACA.First, he noted that the ACA prohibits annual and lifetime dollar limits on services as of 2014. For states with specific dollar caps on specific autism treatments, “It’s not clear that you’ll be able to maintain an expenditure cap for a service you offer.”

For example, Florida’s mandate includes a $200,000 lifetime limit on autism treatments.He sees even more possibilities for ACA to improve coverage for autism treatment based on how HHS defines the required category of “habilitative services.” Generally, these are services that help patients achieve new life skills, as opposed to rehabilitative services, which restore functions that have been lost. In February 2012, HHS advised that three categories of benefits — pediatric oral services, pediatric vision services, and habilitative services — were generally not included in benchmark plans and would have to be added by the states. Guidance on exactly how to do that is still pending.

Mandates may be moot

“The mandates in some ways may be moot…if states all include habilitative services in their package, and include them in an intensity that is appropriate for these kids,” Mandell suggested. “The thing is, insurance companies are already selectively providing [habilitative] services, like speech therapy and physical therapy.”The states are hedging their bets in recently passed mandates. A number have specifically addressed the uncertainty of how a state mandate would interact with the ACA’s essential benefits package. For example, Arkansas’ new autism mandate, effective October 2011, caps benefits for applied behavioral analysis at $50,000 and applies an age cap of 18 years old. It specifically states that “To the extent that this section requires benefits that exceed the essential health benefits [it] shall not be required of a health benefit plan when the plan is offered by a health care insurer in this state through the state (insurance) exchange.” However, the mandate would continue to apply to plans offered outside the state insurance exchange, which presumably would not be subsidized. California and Rhode Island have put similar provisions into their recent mandates to ensure that the state would not be footing the bill in 2014.One thing the states cannot do, however, is to pass new mandates in an effort to have them included in the essential health benefits package. By regulation, any state mandate enacted after December 31, 2011 cannot be part of the state’s package in 2014 or 2015.

State benchmark plans

Already, a few states have selected their benchmark plans. In California, the health committees in both the Senate and Assembly passed legislation to select the Kaiser small group HMO plan as its benchmark for 2014. The author of the bill in the California Senate, Democrat and optometrist Ed Hernandez, noted that the selection “recognize[s] the importance of existing state-mandated benefits and incorporate[s] as many state mandates as possible.

“In March, Washington became the first state to select its benchmark, directing its insurance commissioner to choose the largest small group plan by enrollment. That choice should make the state mandates part of the essential benefits package for 2014 and 2015, but lawmakers are taking no chances with the state budget in the future. The fate of each mandate rests on whether it imposes costs on the state, and whether the state is willing to appropriate funds to cover the benefit for health exchange enrollees. If it’s not willing, then the mandate will not be enforced for any plan in the market.~ ~ ~

Janet Weiner, MPH, is Associate Director for Health Policy at the Leonard Davis Institute of Health Economics within the University of Pennsylvania. She holds a journalism degree from Northwestern University, a masters degree in public health from Johns Hopkins University, and is currently a doctoral candidate in City and Regional Planning at Penn.

The Autism Community Is Not The Autistic Community

* The “autism community” is not the Autistic Community. The autism community was created by non-Autistic led organizations and includes mostly parents, professionals and their friends. Most of what the world knows about autism is sourced from the non-Autistic “autism community.”

ABLE Co-sponsors

July 11, 2012

S.313 (78)

Sen. Robert Casey [D-PA]

Sen. Lamar Alexander [R-TN]
Sen. Kelly Ayotte [R-NH]
Sen. Tammy Baldwin [D-WI]
Sen. Mark Begich [D-AK]
Sen. Richard Blumenthal [D-CT]
Sen. Roy Blunt [R-MO]
Sen. Cory Booker [D-NJ]
Sen. John Boozman [R-AR]
Sen. Barbara Boxer [D-CA]
Sen. Sherrod Brown [D-OH]
Sen. Richard Burr [R-NC]
Sen. Maria Cantwell [D-WA]
Sen. Benjamin Cardin [D-MD]
Sen. Thad Cochrane [R-MS]
Sen. Susan Collins [R-ME]
Sen. Christopher Coons [D-DE]
Sen. Joseph Donnelly [D-IN]
Sen. Richard Durbin [D-IL]
Sen. Michael Enzi [R-WY]
Sen. Diane Feinstein [D-CA]
Sen. Deb Fischer [R-NE]
Sen. Al Franken [D-MN]
Sen. Kirsten Gillibrand [D-NY]
Sen. Chuck Grassley [R-IA]
Sen. Kay Hagan [D-NC]
Sen. Tom Harkin [D-IA]
Sen. Orrin Hatch [R-UT]
Sen. Martin Heinrich [D-NM]
Sen. Heidi Heitkamp [D-ND]
Sen. Dean Heller [R-NV]
Sen. Mazie Hirono [D-HI]
Sen. John Hoeven [R-ND]
Sen. James Inhofe [R-OK]
Sen. Johnny Isakson [R-GA]
Sen. Mike Johanns [R-NE]
Sen. Tim Johnson [D-SD]
Sen. Tim Kaine [D-VA]
Sen. Angus King [I-ME]
Sen. Mark Kirk [R-IL]
Sen. Amy Klobuchar [D-MN]
Sen. Mary Landrieu [D-LA]
Sen. Frank Lautenberg [D-NJ]
Sen. Patrick Leahy [D-VT]
Sen. Mike Lee [R-UT]
Sen. Ed Markey [D-MA]
Sen. Mitch McConnell [R-KY]
Sen. Bob Menendez [D-NJ]
Sen. Jeff Merkley [D-OR]
Sen. Barbara Mikulski [D-MD]
Sen. Jerry Moran [R-KS]
Sen. Lisa Murkowski [R-AK]
Sen. Chris Murphy [D-CT]
Sen. Bill Nelson [D-FL]
Sen. Rob Portman [R-OH]
Sen. Mark Pryor [D-AR]
Sen. Jack Reed [D-RI]
Sen. Harry Reid [D-NV]
Sen. Pat Roberts [R-KS]
Sen. John Rockefeller [D-WV]
Sen. Marco Rubio [R-FL]
Sen. Bernard Sanders [I-VT]
Sen. Brian Schatz [D-HA]
Sen. Chuck Schumer [D-NY]
Sen. Tim Scott [R-SC]
Sen. Jeanne Shaheen [D-NH]
Sen. Debbie Stabenow [D-MI]
Sen. Jon Tester [D-MT]
Sen. John Thune [R-SD]
Sen. Pat Toomey [R-PA]
Sen. Mark Udall [D-CO]
Sen. Tom Udall [D-NM]
Sen. David Vitter [R-LA]
Sen. John Walsh [D-MT]
Sen. Elizabeth Warren [D-MA]
Sen. Mark Warner [D-VA]
Sen. Sheldon Whitehouse [D-RI]
Sen. Roger Wicker [R-MS]

HR.647 (381)

Rep. Ander Crenshaw [R-FL4]



Rep. Jo Bonner/Bradley Byrne [R-1]
Pep. Martha Roby [R-2]
Rep. Mike Rogers [R-3]
Rep. Spencer Bachus [R-6]
Rep. Terri Sewell [D-7]

Rep. Don Young [R-At Large]

Rep. Ann Kirkpatrick [D-1]
Rep. Ron Barber [D-2]
Rep. Paul Gosar [R-4]
Rep. Matt Salmon [R-5]
Rep. David Schweikert [R-6]
Rep. Trent Franks [R-8]
Rep. Kyrsten Sinema [D-9]

Rep. Rick Crawford [R-1]
Rep. Tim Griffin [R-2]
Rep. Steve Womack [R-3]
Rep. Tom Cotton [R-4]

Rep. Doug LaMalfa [R-1]
Rep. Jared Huffman [D-2]
Rep. John Garamendi [D-3]
Rep. Tom McClintock [R-4]
Rep. Mike Thompson [D-5]
Rep. Doris Matsui [D-6]
Rep. Ami Bera [D-7]
Rep. Paul Cook [R-8]
Rep. Jerry McNerny [D-9]
Rep. Jeff Denhan [R-10]
Rep. Barbara Lee [D-13]
Rep. Jackie Speier [D-14]
Rep. Eric Swalwell [D-15]
Rep. Jim Costa [D-16]
Rep. Mike Honda [D-17]
Rep. Anna Eshoo [D-18]
Rep. Zoe Lofgren [D-19]
Rep. Sam Farr [D-20]
Rep. David Valadao [R-21]
Rep. Devin Nunes [R-22]
Rep. Lois Capps [D-24]
Rep. Buck McKeon [R-25]
Rep. Julia Brownley [D-26]
Rep. Judy Chu [D-27]
Rep. Adam Schiff [D-28]
Rep. Tony Cardenas [D-29]
Rep. Brad Sherman [D-30]
Rep. Grace Napolitano [D-32]
Rep. Gloria Negrete McLeod [D-35]
Rep. Raul Ruiz [D-36]
Rep. Karen Bass [D-37]
Rep. Linda Sanchez [D-38]
Rep. Ed Royce [R-39]
Rep. Lucille Roybal-Allard [D-40]
Rep. Mark Takano [D-41]
Rep. Ken Calvert [R-42]
Rep. Maxine Waters [D-43]
Rep. Janice Hahn [D-44]
Rep. Loretta Sanchez [D-46]
Rep. Alan Lowenthal [D-47]
Rep. Duncan Hunter [R-50]
Rep. Juan Vargas [D-51]
Rep. Scott Peters [D-52]
Rep. Susan Davis [D-53]

Rep. Jared Polis [D-2]
Rep. Scott Tipton [R-3]
Rep. Cory Gardner [R-4]
Rep. Mike Coffman [R-6]
Rep. Ed Perlmutter [D-7]

Rep. John Larson [D-1]
Rep. Joe Courtney [D-2]
Rep. Rosa DeLauro [D-3]
Rep. James Himes [D-4]
Rep. Elizabeth Esty [D-5]

Rep. John Carney [D-At Large]

District of Columbia
Rep. Eleanor Holmes-Norton [D-At Large]

Rep. Jeff Miller [R-1]
Rep. Steve Southerland [R-2]
Rep. Ted Yoho [R-3]
Rep. Corrine Brown [D-5]
Rep. Ron DeSantis [R-6]
Rep. John Mica [R-7]
Rep. Bill Posey [R-8]
Rep. Alan Grayson [D-9]
Rep. Daniel Webster [R-10]
Rep. Richard Nugent [R-11]
Rep. Gus Bilirakis [R-12]
Rep. C.W. Bill Young/David Jolly [R-13]
Rep. Kathy Castor [D-14]
Rep. Dennis Ross [R-15]
Rep. Vern Buchanan [R-16]
Rep. Thomas Rooney [R-17]
Rep. Patrick Murphy [R-18]
Rep. Trey Radel [R-19]
Rep. Alcee Hastings [D-20]
Rep. Theodore Deutch [D-21]
Rep. Lois Frankel [D-22]
Rep. Debbie Wasserman Schultz [D-23]
Rep. Frederica Wilson [D-24]
Rep. Mario Diaz-Balart [R-25]
Rep. Joe Garcia [D-26]
Rep. Ileana Ros-Lehtinen [D-27]

Rep. Sanford Bishop [D-2]
Rep. Lynn Westmoreland [R-3]
Rep. Hank Johnson [D-4]
Rep. John Lewis [D-5]
Rep. Tom Price [R-6]
Rep. Austin Scott [R-8]
Rep. Doug Collins [R-9]
Rep. Paul Broun [R-10]
Rep. Phil Gingrey [R-11]
Rep. David Scott [D-13]

Rep. Tulsi Gabbard [D-HI]

Rep. Michael Simpson [R-2]

Rep. Bruce Braley [D-1]
Rep. David Loesback [D-2]
Rep. Tom Latham [R-3]

Rep. Bobby Rush [D-1]
Rep. Dan Lipinski [D-3]
Rep. Luis Gutierrez [D-4]
Rep. Mike Quigley [D-5]
Rep. Peter Roskam [R-6]
Rep. Danny Davis [D-7]
Rep. Tammy Duckworth [D-8]
Rep. Janice Schakowsky [D-9]
Rep. Brad Schneider [D-10]
Rep. William Enyart [D-12]
Rep. Rodney Davis [R-13]
Rep. Randy Hultgren [R-14]
Rep. Adam Kinzinger [R-16]
Rep. Cheri Bustos [D-17]
Rep. Aaron Schock [R-18]

Rep. Pete Visclosky [D-1]
Rep. Jackie Walorski [R-2]
Rep. Marlin Stutzman [R-3]
Rep. Todd Rokita [R-4]
Rep. Susan Brooks [R-5]
Rep. Luke Messer [R-6]
Rep. Andre Carson [D-7]
Rep. Larry Bucshon [R-8]
Rep. Todd Young [R-9]

Rep. Lynn Jenkins [R-2]
Rep. Kevin Yoder [R-3]
Rep. Mike Pompeo [R-4]

Rep. Ed Whitfield [R-1]
Rep. Brett Guthrie [R-2]
Rep. John Yarmuth [D-3]
Rep. Thomas Massie [R-4]
Rep. Hal Rogers [R-5]
Rep. Andy Barr [R-6]

Rep. Steve Scalise [R-1]
Rep. Cedric Richmond [D-2]
Rep. Charles Boustany [R-3]
Rep. John Fleming [R-4]
Rep. Vance McAllister [R-5]
Rep. Bill Cassidy [R-6]

Rep. Chellie Pingree [D-1]
Rep. Mike Michaud [D-2]

Rep. Andy Harris [R-1]
Rep. Dutch Ruppersberger [D-2]
Rep. John Sarbanes [D-3]
Rep. Donna Edwards [D-4]
Rep. John Delaney [D-6]
Rep. Elijah Cummings [D-7]
Rep. Chris Van Hollen [D-8]

Rep. Richard Neal [D-1]
Rep. James McGovern [D-2]
Rep. Niki Tsongas [D-3]
Rep. Joseph P. Kennedy III [D-4]
Rep. Katherine Clark [D-5]
Rep. John Tierney [D-6]
Rep. Michael Capuano [D-7]
Rep. Stephen Lynch [D-8]
Rep. William Keating [D-9]

Rep. Dan Benishek [R-1]
Rep. Bill Huizenga [R-2]
Rep. Dan Kildee [D-5]
Rep. Fred Upton [R-6]
Rep. Tim Walberg [R-7]
Rep. Candice Miller [R-10]
Rep. Kerry Bentivolio [R-11]
Rep. John Conyers [D-13]
Rep. Gary Peters [D-14]

Rep. Tim Walz [D-1]
Rep. John Kline [R-2]
Rep. Erik Paulsen [D-3]
Rep. Betty McCollum [D-4]
Rep. Keith Ellison [D-5]
Rep. Michele Bachmann [R-6]
Rep. Collin Peterson [D-7]
Rep. Rick Nolan [D-8]

Rep. Alan Nunnelee [R-1]
Rep. Gregg Harper [R-3]
Rep. Steven Palazzo [R-4]

Rep. William Lacy Clay [D-1]
Rep. Ann Wagner [R-2]
Rep. Blaine Luetkemeyer [R-3]
Rep. Vicky Hartzler [R-4]
Rep. Emanuel Cleaver [D-5]
Rep. Sam Graves [R-6]
Rep. Billy Long [R-7]

Rep. Steve Daines [R-At Large]

Rep. Jeff Fortenberry [R-1]
Rep. Lee Terry [R-2]

Rep. Dina Titus [D-1]
Rep. Mark Amodei [R-2]
Rep. Joe Heck [R-3]
Rep. Steven Horsford [D-4]

New Hampshire
Rep. Carol Shea-Porter [D-1]
Rep. Ann Kuster [D-2]

New Jersey
Rep. Rob Andrews [D-1]
Rep. Frank LoBiondo [R-2]
Rep. Jon Runyan [R-3]
Rep. Chris Smith [R-4]
Rep. Frank Pallone [D-6]
Rep. Leonard Lance [R-7]
Rep. Albio Sires [D-8]
Rep. Bill Pascrell [D-9]
Rep. Donald Payne [D-10]
Rep. Rodeny Frelinghuysen [R-11]
Rep. Rush D. Holt [D-12]

New Mexico
Rep. Michelle Lujan Grisham [D-1]
Rep. Stevan Pearce [R-2]
Rep. Ben Ray Lujan [D-3]

New York
Rep. Timothy Bishop [D-1]
Rep. Peter T. King [R-2]
Rep. Steve Israel [D-3]
Rep. Carolyn McCarthy [D-4]
Rep. Gregory Meeks [D-5]
Rep. Grace Meng [D-6]
Rep. Nydia Velazquez [D-7]
Rep. Hakeem Jeffries [D-8]
Rep. Yvette Clarke [D-9]
Rep. Jerrold Nadler [D-10]
Rep. Michael Grimm ([R-11]
Rep. Carolyn Maloney [D-12]
Rep. Charles Rangel [D-13]
Rep. Joseph Crowley [D-14]
Rep. Jose Serrano [D-15]
Rep. Eliot Engel [D-16]
Rep. Nita Lowey [D-17]
Rep. Sean Patrick Maloney [D-18]
Rep. Chris Gibson [R-19]
Rep. Paul Tonko [D-20]
Rep. Bill Owens [D-21]
Rep. Richard Hanna [R-22]
Rep. Tom Reed [R-23]
Rep. Daniel Maffei [D-24]
Rep. Louise Slaughter [D-25]
Rep. Brian Higgins [D-26]

North Carolina
Rep. G.K. Butterfield [D-1]
Rep. Renee Ellmers [R-2]
Rep. Walter Jones [R-3]
Rep. David Price [D-4]
Rep. Howard Coble [R-6]
Rep. Mark McIntyre [D-7]
Rep. Richard Hudson [R-8]
Rep. Robert Pittenger [R-9]
Rep. Patrick McHenry [R-10]
Rep. Mark Meadows [R-11]
Rep. George Holding [R-13]

North Dakota
Rep. Kevin Cramer [R-At Large]

Northern Mariana Islands
Rep. Gregorio Camacho Sablan [D-At Large]

Rep. Steve Chabot [R-1]
Rep. Brad Wenstrup [R-2]
Rep. Joyce Beatty [D-3]
Rep. Jim Jordan [R-4]
Rep. Bob Latta [R-5]
Rep. Bill Johnson [R-6]
Rep. Bob Gibbs [R-7]
Rep. Marcy Kaptur [D-9]
Rep. Michael Turner [R-10]
Rep. Marcia Fudge [D-11]
Rep. Pat Tiberi [R-12]
Rep. Tim Ryan [D-13]
Rep. David Joyce [R-14]
Rep. Steve Stivers [R-15]
Rep. James Renacci [R-16]

Rep. Tom Cole [R-4]

Rep. Suzanne Bonamici [D-1]
Rep. Greg Walden [R-2]
Rep. Earl Blumenauer [D-3]
Rep. Peter DeFazio [D-4]
Rep. Kurt Schrader [D-5]

Rep. Robert Brady [D-1]
Rep. Chaka Fattah [D-2]
Rep. Mike Kelly [R-3]
Rep. Glenn Thompson [R-5]
Rep. Jim Gerlach [R-6]
Rep. Patrick Meehan [R-7]
Rep. Mike Fitzpatrick [R-8]
Rep. Tom Marino [R-10]
Rep. Lou Barletta [R-11]
Rep. Keith Rothfus [R-12]
Rep. Allyson Schwartz [D-13]
Rep. Mike Doyle [D-14]
Rep. Charlie Dent [R-15]
Rep. Matt Cartwright [D-17]
Rep. Tim Murphy [R-18]

Puerto Rico
Rep. Pedro Pierluisi [D-At Large]

Rhode Island
Rep. David Cicilline [D-1]
Rep. James R. Langevin [D-2]

South Carolina
Rep. Joe Wilson [R-2]
Rep. Mick Mulvaney [R-5]
Rep. Tom Rice [R-7]

South Dakota
Rep.Kristi Noem [R-At Large]

Rep. David Roe [R-1]
Rep. John Duncan [R-2]
Rep. Chuck Fleischmann [R-3]
Rep. Scott DesJarlais [R-4]
Rep. Jim Cooper [D-5]
Rep. Diane Black [R-6]
Rep. Marsha Blackburn [R-7]
Rep. Stephen Lee Fincher [R-8]
Rep. Steve Cohen [D-9]

Rep. Ted Poe [R-2]
Rep. Sam Johnson [R-3]
Rep. Ralph Hall [R-4]
Rep. Jeb Hensarling [R-5]
Rep. Joe Barton [R-6]
Rep. John Culberson [R-7]
Rep. Kevin Brady [R-8]
Rep. Al Green [D-9]
Rep. Michael McCaul [R-10]
Rep. Michael Conaway [R-11]
Rep. Kay Granger [R-12]
Rep. Mac Thornberry [R-13]
Rep. Ruben Hinojosa [D-15]
Rep. Beto O’Rourke [D-16]
Rep. Bill Flores [R-17]
Rep. Sheila Jackson Lee [D-18]
Rep. Randy Neugebauer [R-19]
Rep. Joaquin Castro [D-20]
Rep. Lamar Smith [R-21]
Rep. Pete Olson [R-22]
Rep. Pete Gallego [D-23]
Rep. Kenny Marchant [R-24]
Rep. Roger Williams [R-25]
Rep. Michael Burgess [R-26]
Rep. Blake Farenthold [R-27]
Rep. Henry Cuellar [D-28]
Rep. Eddie Bernice Johnson [D-30]
Rep. John Carter [R-31]
Rep. Pete Sessions [R-32]
Rep. Marc Veasey [D-33]
Rep. Filemon Vela [D-34]
Rep. Lloyd Doggett [D-35]
Rep. Steve Stockman [R-36]

Rep. Rob Bishop [R-1]
Rep. Jim Matheson [D-4]

Rep. Peter Welch [D-At Large]

Rep. Rob Wittman [R-1]
Rep. Scott Rigell [R-2]
Rep. Randy Forbes [R-4]
Rep. Robert Hurt [R-5]
Rep. Bob Goodlatte [R-6]
Rep. James Moran [D-8]
Rep. Morgan Griffith [R-9]
Rep. Frank R. Wolf [R-10]
Rep. Gerald E. “Gerry” Connolly [D-11]

Rep. Suzan DelBene [D-1]
Rep. Rick Larsen [D-2]
Rep. Jaime Herrera Beutler [R-3]
Rep. Doc Hastings [R-4]
Rep. Cathy McMorris Rodgers [R-5]
Rep. Derek Kilmer [D-6]
Rep. Jim McDermott [D-7]
Rep. Dave Reichert [R-8]
Rep. Denny Heck [D-10]

West Virginia
Rep. David McKinley [R-1]
Rep. Shelley Moore Capito [R-2]
Rep. Nick Rahall [D-3]

Rep. Mark Pocan [D-2]
Rep. Ron Kind [D-3]
Rep. Gwen Moore [D-4]
Rep. James Sensenbrenner [R-5}
Rep. Sean Duffy [R-7]
Rep. Reid Ribble [R-8]


Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid. 

ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.

The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t workIn study after repeated study: ABA (conversion therapy) doesn’t work. 

What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.

The ‘cure’ for Autistics not born yet is the prevention of birth. 

The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome. 

This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.

Fact: You can’t cure Autistics from being Autistic.

Fact: You can’t recover an Autistic from being Autistic.

Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.

[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]

Fact: Vaccines Do Not Cause Autism.

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