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It’s the ‘gold standard’ in autism care. Why are states reining it in?

States reduce Medicaid spending on ABA autism therapy due to budget shortfalls, leading to halved therapy hours for some children and legal challenges from families and providers.

  • Earlier this year, state Medicaid programs reduced provider payments and capped ABA therapy hours, with Above and Beyond Therapy citing provider rate cuts in Nebraska.
  • Amid mounting budget strains, state officials cited shortfalls and federal audits alleged improper payments in Indiana and Wisconsin, prompting Medicaid funding cuts for autism ABA therapy.
  • ABA therapy typically ranges from 10 to 40 hours weekly, with some children receiving at-home ABA technician visits five days a week, while families report rapid progress and sometimes must repeatedly contact Medicaid to restore care.
  • Families and providers filed lawsuits, including families of 21 children and Colorado providers and parents, while North Carolina Gov. Josh Stein canceled October cuts in early December.
  • Advocates warn that steep cuts of 28% to 79% could jeopardize access as state Medicaid programs lack funds, and some families previously filed for bankruptcy to pay for ABA out of pocket.
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It’s the ‘gold standard’ in autism care. Why are states reining it in?

By Bram Sable-Smith and Andrew Jones, KFF Health News ALEXANDER, N.C. — Aubreigh Osborne has a new best friend. Dressed in blue with a big ribbon in her blond curls, the 3-year-old sat in her mother’s lap carefully enunciating a classmate’s first name after hearing the words “best friend.” Just months ago, Gaile Osborne didn’t expect her adoptive daughter would make friends at school. Diagnosed with autism at 14 months, Aubreigh Osborne started …

·Deerfield Beach, United States
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Pioneer Press broke the news in Saint Paul, United States on Thursday, January 8, 2026.
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