If you’ve been following the news lately, you may have seen headlines about Medicaid and autism therapy that made your stomach drop. You’re not imagining things, and you’re not alone in worrying about it. Across the country — and right here in Florida — families are navigating real disruptions to Applied Behavior Analysis (ABA) coverage, and it’s worth talking about plainly: what’s happening, why, and what you can do if it touches your family.
What’s actually going on
In Palm Beach County this summer, several families connected to a local ABA provider said Medicaid abruptly stopped covering their children’s therapy, with little explanation from the state. Daura Mabel Sanchez Cano de Fundora described watching her son David lose access to a therapy that had helped him build vocabulary and form sentences. “How can you deny a service that can decide the life of those children and those parents?” she asked. Other parents described painful regressions once services stopped — self-injurious behaviors returning, meltdowns families thought they’d worked through starting up again.
Florida hasn’t technically “cut” ABA from Medicaid. Instead, the state shifted authorization decisions to private managed care plans, which now control approvals and paperwork. In practice, for the families affected, the result has felt the same: a service their child depended on simply stopped.
This isn’t happening in isolation. States including North Carolina, Nebraska, Colorado, and Indiana have all trimmed ABA reimbursement rates or added new authorization hurdles this year, as Medicaid spending on the therapy has climbed sharply nationwide — driven largely by more children being diagnosed and seeking care, not by the therapy itself becoming less necessary. Federal audits in several states have also flagged improper billing by a small number of providers, and regulators say tightening oversight is part of the goal. But for the vast majority of families doing everything right, the tightening has landed as delays, denials, and confusion.
One story that stuck with us: a North Carolina mother, Gaile Osborne, watched her 3-year-old daughter Aubreigh’s therapy hours cut in half overnight after a state Medicaid change — then restored only after weeks of Osborne personally calling everyone she could reach in the state’s Medicaid system. “It’s not perfect,” she said of ABA’s impact on her daughter, “but the growth in under a year is just unreal.” Her persistence worked. Not every family has the time, knowledge, or bandwidth to fight that hard — which is exactly why we think it’s worth talking about here.
What this means for your family
If your child receives ABA through Medicaid or a managed care plan, a few things are worth doing now, before you’re in a crisis:
Ask your BCBA or provider directly about authorization status. Don’t wait for a denial letter. Ask now whether your child’s current hours are authorized through a specific date, and what the renewal timeline looks like.
Keep your own paper trail. Save authorization letters, session notes, and any communication with your managed care plan. If a denial does come, you’ll want dates and documentation on hand.
Know that denials can be appealed. Managed care plans are required to have an appeals process, and many families have successfully had services reinstated by escalating persistently and in writing — as both the Osborne and Palm Beach County cases show. Your provider’s office can often help you navigate this.
Loop in your care team early. Pediatricians, neurologists, and school-based support staff can write letters of medical necessity that strengthen an appeal.
Connect with other families. Parent networks and advocacy groups are often the fastest way to hear about coverage changes before they become official news — and to find out you’re not the only one dealing with it.
The bigger picture
None of this changes what we know clinically: consistent, individualized ABA support helps many autistic children build communication, independence, and safety skills that ripple through every part of family life. The systems around that care are shifting — sometimes for legitimate reasons like fraud prevention, sometimes in ways that seem to hurt the families who least deserve the disruption. Our job, as always, is to help you understand your child’s care and to be a steady, honest resource when the landscape around it gets complicated.
If you have questions about your own child’s authorization, coverage, or what to expect from us, please reach out. We’d rather talk it through with you now than have you find out something changed by surprise.
Sources
- Florida families fight Medicaid cuts to autism therapy, say children lost access without warning — WFLX/Gray Media, July 2026
- It’s the ‘gold standard’ in autism care. Why are states reining it in? — NPR/KFF Health News, December 2025
- NC moves to rein in soaring autism therapy costs — North Carolina Health News, April 2026
