Autism Speaks | NJ.com: ‘Autism Community Benefits From Affordable Care Act’ | May 29, 2014 #AutisticHistory #BanABA #EndAutismSpeaks


Ban ABA

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


NJ.com: ‘Autism Community Benefits From Affordable Care Act’

May 29, 2014

(May 29, 2014) — Families facing expensive autism treatments are finding some positive results in New Jersey’s implementation of the Affordable Care Act (ACA), according to an article published today on NJ.com.

The main focus of parental concern is payment for Applied Behavior Analysis, or ABA, therapy. In such sessions, an ABA specialist instructs the child on the basics — recognizing objects, learning to point, using scissors or makinng eye contact — by laborious repetition.

“With some kids, that requires really intensive services,” Autism Speaks’ director of state government affairs Judith Ursitti told NJ.com.

The ACA prohibits yearly and lifetime dollar caps on essential health benefits, including behavioral therapy and habilitative services. As a result, a $36,000 annual cap on ABA benefits in New Jersey’s 2009 autism insurance reform law was voided. 

“New Jersey is one of the few states that have said these dollar caps are illegal under federal health care parity,” Ursitti told NJ.com.

Insurance carriers in other states are attempting to get around the prohibition on dollar caps by converting them into limits on the number of visits.

“It’s ridiculous,” Ursitti said. “It’s a cap.” In some cases, she said, plans have limited coverage to eight hours of treatment a week.


Autism community benefits from Affordable Care Act

By Kathleen O’Brien | NJ Advance Media for NJ.com 
on May 29, 2014 at 7:00 AM, updated May 29, 2014 at 7:25 AM

When Heather Saffert’s 3-year-old son was diagnosed with autism late last year, the Middletown woman reduced her work schedule so she could spend more time overseeing his care.

That switch to part-time status meant she no longer had health insurance, so she looked at policies on the federal Obamacare marketplace. She ended up picking one of the more expensive plans that offered lower co-pays for every health care visit.

The reason? She knows her son will need behavioral therapy, along with speech therapy, occupational therapy and possibly physical therapy. That’s a lot of co-pays.

The inclusion of behavioral therapy as one of the 10 “essential services” that every health insurance plan must offer to comply with the Affordable Care Act gives the autism community a second pathway — besides their local schools — to get services covered.

“Autism is a neurological condition, so the treatment of it should be included in health insurance,” said Suzanne Buchanan, executive director of Autism New Jersey. While children as young as preschoolers often receive services through the local school district, that doesn’t cover all their needs, she said. 

“Autism happens 24/7,” she said. “It doesn’t impact the child just at school. It’s not only an educational condition.”

The main focus of parental concern is payment for Applied Behavior Analysis, or ABA, therapy. In such sessions, an ABA specialist instructs the child on the basics — recognizing objects, learning to point, using scissors or makinng eye contact — by laborious repetition. 

“With some kids, that requires really intensive services,” said Judith Ursitti, director of state government affairs for the national headquarters of Autism Speaks. She likens it to the breakthrough sessions in which Annie Sullivan managed to reach the blind Helen Keller.

Since autism disorder encompasses a wide range of severity, the treatment may vary greatly from child to child. A high-functioning child with the milder form called Asperger’s may never need an hour of ABA, Ursitti said. More severely impacted children could easily need 25 hours of therapy a week, particularly when they are little. 

The going rate — without insurance — ranges from $75 to $125 an hour, said Saffert.
A 2009 New Jersey law already required most insurance policies to cover autism treatment. 

Under Obamacare, coverage will be even more robust, because the federal law prohibits yearly or lifetime dollar amount limits on essential health benefits. That means a provision in the 2009 New Jersey regulation allowing a cap of $36,000 per year for ABA no longer applies.

That puts New Jersey parents in a relatively good position compared to parents in other states, said Ursitti. “New Jersey is one of the few states that have said these dollar caps are illegal under federal health care parity,” she said. 

In other states, insurance carriers have gotten around the dollar cap by converting the money into hours of treatment, she said. “It’s ridiculous,” she said. “It’s a cap.” In some cases, she said, plans have limited coverage to eight hours of treatment a week.

U.S. Sen. Robert Menendez (D-N.J.) recently raised the issue of hourly caps during the confirmation hearing for the nominee for new Secretary of Health and Human Services, Sylvia Mathews Burwell. Menendez helped write the requirement that autism services be considered “essential” under the landmark overhaul of health insurance.

“This is clearly in violation of the intent of the provision as I authored it, and is part of the law, and has the potential to deny access to care to families across the country,” he told Burwell. 

Buchanan, of Autism New Jersey, said her group is working with the state’s insurance carriers to standardize the codes and requirements for ABA reimbursement, and is making progress. 

The process of establishing a treatment plan, along with reimbursement for it, has been lengthy for Saffert, who has been working at it for several months now. When shopping for a plan, insurance sales staff usually didn’t know the particulars of their autism coverage. Now that she has purchased a policy, she’s been getting referrals and lining up therapists for her son.

“Had I realized how long everything takes to get in motion, I would’ve started earlier,” she said.


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.”


Note/Warning:

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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