Making Sense of Federal HealthCare Reform

Update:  March 24, 2017

GOP health-care bill: House Republican leaders abruptly pull their rewrite of the nation’s health-care law
Washington Post

House Republican leaders abruptly pulled a Republican rewrite of the nation’s health-care system from consideration on Friday, a dramatic acknowledgment that they are so far unable to repeal the Affordable Care Act.  Read full article>>

For now, the legislation under consideration to repeal the Affordable Care Act has been halted.  We'll continue to monitor this important issue.  

 

March 8, 2017

With the recent release of the House Republican's long awaited plan for the repeal of the Affordable Care Act (ACA) and the overhaul of the country’s healthcare system, Autism New Jersey shares the concerns of many within our community on what impact the proposed legislation will have on individuals with autism. We are currently in the process of analyzing the draft legislation that was released on March 6 in order to determine what effect these changes will have on the autism community. Although we are not yet certain of the impact of the proposed legislation, we can be certain that the repeal of the ACA is a cause for concern.

 

If the ACA were to be repealed, individuals with autism in New Jersey whose plans are subject to the state Autism and Other Developmental Disabilities mandate would still have access to coverage for diagnostic and medically necessary services. Although the state mandate would ensure that coverage is available, the terms of the coverage could change. For instance, the state’s mandate, when passed in 2009, came with a cost limit of $36,000 a year for ABA services. With the passage of the ACA, the cost limit associated with the state mandate was eliminated, so any ACA repeal and replacement plan could possibly reintroduce that limit. In addition, the elimination of subsidies to help with the cost of individual health plans could make this option unaffordable to some families. This is clearly an area of concern for our community and one that we will monitor closely as the administration works to repeal and replace the ACA.

Additionally, the proposed reforms would convert federal Medicaid financing to a per capita cap beginning in FY2020. With Medicaid as the primary source of adult service funding via New Jersey’s Division of Developmental Disabilities, these changes could result in eligibility changes, coverage cutbacks and longer waiting lists for Medicaid home and community-based services waivers . States would be granted more control over limited funding.

As we have been for decades, Autism New Jersey is fully committed to working with state officials and sister agencies in order to understand these complex issues and effectuate change. Healthcare coverage for medically necessary treatment for autism is one of our highest priorities, and we will continue to be responsive to your concerns, educate state officials of all political parties of the critical nature of these funding streams and services, and strategically influence the process and outcome in the best interest of individuals with autism. We will continue to provide updates as we learn more about the impact of the proposed legislation and keep you informed of any necessary advocacy efforts.

Additional Resources:

Kaiser Family Foundation
Full text of GOP Plan
Care for Autism and Other Disabilities — A Future in Jeopardy (New England Journal of Medicine, March 9, 2017)

 

Questions? We welcome your questions regarding insurance coverage and are here to help parents and providers navigate the entire process. Call our Helpline at 800.4.AUTISM or email us at information@autismnj.org.


Hot Topic:  Health Insurance

Our Helpline Staff has prepared information to help you understanding and navigate the complex issues surrounding insurance coverage.  Learn more>>


AUTISM NEW JERSEY
500 Horizon Drive, Suite 530 Robbinsville, NJ 08691
Phone: 609.588.8200; 800.4.AUTISM | Fax: 609.588.8858
Email: information@autismnj.org

Instagram