ABA therapy to become a mandatory benefit for federal employees in 2017

Federal Insurance to Cover ABA
Health Insurance for Federal Employees to Cover ABA

The U.S. Office of Personnel Management will now require that all insurance companies participating in the Federal Employees Health Benefits Program cover Applied Behavior Analysis therapy, which can otherwise costs families tens of thousands of dollars.

“For the 2017 plan year, carriers may no longer exclude ABA for the treatment of Autism Spectrum Disorder (ASD). We expect all carriers to offer clinically appropriate and medically necessary treatment for children diagnosed with ASD,” the OPM wrote in its annual “FEHB Program Carrier Letter [PDF],” dated February 26, which lists the agency’s new benefits and proposals.

The OPM first urged all providers to cover ABA therapy in 2013. However, according to data assembled by Autism Speaks, federal employees in just 27 states have access to FEHB health plans with ABA coverage, prompting the OPM to fill the gaps.

“This is absolutely huge news for the autism community. We applaud OPM for stepping up to the plate and requiring ABA coverage for the 8 million people in FEHB plans,” said Lorri Unumb, vice president of state government affairs at Autism Speaks, in a news release.

Forty-three states have passed legislation requiring insurers to provide plans that cover ABA therapy.

According to the latest Center for Disease Control statistics, an estimated 1 in 68 children are born with autism, up from a rate of 1 in 150 as recently as 2000.