{"id":2122385,"date":"2025-12-23T05:00:00","date_gmt":"2025-12-23T10:00:00","guid":{"rendered":"https:\/\/kffhealthnews.org\/?post_type=article&#038;p=2122385"},"modified":"2026-01-06T09:09:28","modified_gmt":"2026-01-06T14:09:28","slug":"aba-therapy-applied-behavior-analysis-autism-medicaid-rate-cuts-north-carolina","status":"publish","type":"article","link":"https:\/\/kffhealthnews.org\/news\/article\/aba-therapy-applied-behavior-analysis-autism-medicaid-rate-cuts-north-carolina\/","title":{"rendered":"It\u2019s the \u2018Gold Standard\u2019 in Autism Care. Why Are States Reining It In?"},"content":{"rendered":"\n<p>ALEXANDER, N.C. \u2014 Aubreigh Osborne has a new best friend.<\/p>\n\n\n\n<p>Dressed in blue with a big ribbon in her blond curls, the 3-year-old sat in her mother\u2019s lap carefully enunciating a classmate\u2019s first name after hearing the words \u201cbest friend.\u201d Just months ago, Gaile Osborne didn\u2019t expect her adoptive daughter would make friends at school.<\/p>\n\n\n\n<aside class=\"block--sidebar alignright \">\n\t\n\n<div class=\"wp-block-kaiser-health-news-partner block--partner\">\n\t\t\t\t\t\t<a class=\"partner__image--link\" href=\"https:\/\/www.npr.org\/sections\/shots-health-news\/2025\/12\/23\/nx-s1-5643014\/autism-aba-therapy-medicaid-costs\">\n\t\t\t\t<img decoding=\"async\" class=\"partner__image\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2022\/07\/npr-hi-res-logo.png?w=120\" alt=\"Partner logo\" \/>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t<p class=\"partner__content\">\n\t\tThis story also ran on <a href=\"https:\/\/www.npr.org\/sections\/shots-health-news\/2025\/12\/23\/nx-s1-5643014\/autism-aba-therapy-medicaid-costs\">NPR<\/a>. It can be <a href=\"https:\/\/kffhealthnews.org\/news\/article\/aba-therapy-applied-behavior-analysis-autism-medicaid-rate-cuts-north-carolina\/view\/republish\/\">republished for free<\/a>.\t<\/p>\n<\/div>\n\n<\/aside>\n\n\n\n<p>Diagnosed with autism at 14 months, Aubreigh Osborne started this year struggling to control outbursts and sometimes hurting herself. Her trouble with social interactions made her family reluctant to go out in public.<\/p>\n\n\n\n<p>But this summer, they started applied behavior analysis therapy, commonly called ABA, which often is used to help people diagnosed with autism improve social interactions and communication. A tech comes to the family\u2019s home five days a week to work with Aubreigh.<\/p>\n\n\n\n<p>Since then, she has started preschool, begun eating more consistently, succeeded at toilet training, had a quiet, in-and-out grocery run with her mom, and made a best friend. All firsts.<\/p>\n\n\n\n<p>\u201cThat\u2019s what ABA is giving us: moments of normalcy,\u201d Gaile Osborne said.<\/p>\n\n\n\n<p>But in October, Aubreigh\u2019s weekly therapy hours were abruptly halved from 30 to 15, a byproduct of her state\u2019s effort to cut Medicaid spending.<\/p>\n\n\n<div class=\"block--iframe\">\n\t<iframe\n\t\tallow=\"fullscreen\"\n\t\tframeborder=\"0\"\n\t\theight=\"280\"\n\t\tsrc=\"https:\/\/www.npr.org\/player\/embed\/nx-s1-5643014\/nx-s1-9585456\"\n\t\twidth=\"100%\"\n\t><\/iframe>\n<\/div>\n\n\n\n<p>Other families around the country have also recently had their access to the therapy challenged as state officials make deep cuts to Medicaid \u2014 the public health insurance that covers people with low incomes and disabilities. North Carolina attempted to cut payments to ABA providers by 10%. Nebraska cut payments by nearly 50% for some ABA providers. Payment reductions also are on the table in Colorado and Indiana, among other states.<\/p>\n\n\n\n<p>Efforts to scale back come as state Medicaid programs have seen spending on the autism therapy balloon in recent years. Payments for the therapy in North Carolina, which were $122 million in fiscal year 2022, are <a href=\"https:\/\/medicaid.ncdhhs.gov\/policy-paper-ensuring-person-centered-care-children-autism-spectrum-disorder-nc-medicaid-program\/open\">projected to hit $639 million<\/a> in fiscal 2026, a 423% increase. Nebraska saw a 1,700% jump in spending in recent years. Indiana saw a 2,800% rise.<\/p>\n\n\n\n<p>Heightened awareness and diagnosis of autism means more families are seeking treatment for their children, which can range from 10 to 40 hours of services a week, according to Mariel Fernandez, vice president of government affairs at the <a href=\"https:\/\/www.casproviders.org\/\">Council of Autism Service Providers<\/a>. The treatment is intensive: Comprehensive therapy can include 30-40 hours of direct treatment a week, while more focused therapy may still consist of 10-25 hours a week, <a href=\"https:\/\/assets-002.noviams.com\/novi-file-uploads\/casp\/pdfs-and-documents\/ASD_Guidelines\/ABA_Practice_Guidelines_3_0-70a721a1.pdf\">according to guidelines<\/a> released by the council.<\/p>\n\n\n\n<p>It\u2019s also a relatively recent coverage area for Medicaid. The federal government <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2014\/08\/26\/343206636\/federal-officials-order-medicaid-to-cover-autism-services\">ordered states to cover<\/a> autism treatments in 2014, but not all covered ABA, which Fernandez called the \u201cgold standard,\u201d until 2022.<\/p>\n\n\n\n<figure class=\"wp-block-image alignwide size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"3840\" height=\"2560\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg\" alt=\"A mother sits with her 3-year-old daughter on a couch in their home. In the background are Christmas decorations.\" class=\"wp-image-2125519\" srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg 3840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=150,100 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=500,333 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=768,512 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=1270,847 1270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=1536,1024 1536w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=2048,1365 2048w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=770,513 770w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=840,560 840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=720,480 720w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=570,380 570w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=370,247 370w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=270,180 270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=170,113 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=100,67 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=120,80 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=1170,780 1170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=300,200 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=200,134 200w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=315,210 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=630,420 630w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_08.jpg?resize=1200,800 1200w\" sizes=\"auto, (max-width: 3840px) 100vw, 3840px\" \/><figcaption class=\"wp-element-caption\">As a result of her therapy, Aubreigh has started preschool and begun eating more consistently. \u201cThat\u2019s what ABA is giving us: moments of normalcy,\u201d says her mother, Gaile.<span class=\"photo-credit\">(Katie Linsky Shaw for KFF Health News)<\/span><\/figcaption><\/figure>\n\n\n<div\n\tclass=\"wp-block block--newsletter  \"\n\tdata-type=\"kaiser-health-news\/newsletter\"\n\tdata-align=\"center\"\n\tstyle=\"\"\n>\n\t<h4 class=\"newsletter__title\">\n\t\t<a href=\"\/email\/\">\n\t\t\tEmail Sign-Up\t\t<\/a>\n\t<\/h4>\n\t<p class=\"newsletter__description\">\n\t\tSubscribe to KFF Health News&#039; free Morning Briefing.\t<\/p>\n\t\n<form\n\taction=\"\/email-signup\/\"\n\tclass=\"kaiser-hubspot-mini-signup-form\"\n\tmethod=\"post\"\n>\n\t<input type=\"hidden\" id=\"kaiser_hubspot_nonce\" name=\"kaiser_hubspot_nonce\" value=\"dc9818bd64\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/article\/2122385\" \/>\t\t\t\t<label\n\t\tclass=\"kaiser-hubspot-mini-signup-form__label--email\"\n\t\tfor=\"kaiser-hubspot-mini-signup-form-email\"\n\t>\n\t\t<span class=\"screen-reader-text\">\n\t\t\tYour Email Address\t\t<\/span>\n\t\t<input\n\t\t\tautocomplete=\"email\"\n\t\t\tclass=\"kaiser-hubspot-mini-signup-form__input--email\"\n\t\t\tid=\"kaiser-hubspot-mini-signup-form-email\"\n\t\t\tname=\"kaiser_hubspot_email\"\n\t\t\ttype=\"email\"\n\t\t\t\t\t\t\tplaceholder=\"Your email address\"\n\t\t\t\t\t\/>\n\t<\/label>\n\t<button class=\"kaiser-hubspot-mini-signup-form__submit\">\n\t\tSign Up\t<\/button>\n<\/form>\n<\/div>\n\n\n\n<p>State <a href=\"https:\/\/kffhealthnews.org\/news\/article\/state-medicaid-cuts-reimbursement-big-bill-north-carolina-idaho-budgets\/\">budget shortfalls<\/a> and the nearly $1 trillion in looming Medicaid spending reductions from President Donald Trump\u2019s One Big Beautiful Bill Act have prompted state budget managers to trim the autism therapy and other growing line items in their Medicaid spending.<\/p>\n\n\n\n<p>So, too, have a series of state and federal audits that raised questions about payments to some ABA providers. A <a href=\"https:\/\/oig.hhs.gov\/documents\/audit\/10124\/A-09-22-02002-highlights.pdf\">federal audit<\/a> of Indiana&#8217;s Medicaid program estimated at least $56 million in improper payments in 2019 and 2020, noting some providers had billed for excessive hours, including during nap time. A similar audit in Wisconsin estimated at least $18.5 million in improper payments in 2021 and 2022. In Minnesota, state officials had <a href=\"https:\/\/kstp.com\/5-investigates\/hundreds-of-autism-centers-popped-up-to-meet-demand-in-minnesota-now-85-are-under-investigation\/\">85 open investigations<\/a> into autism providers as of this summer, after the <a href=\"https:\/\/www.mprnews.org\/story\/2024\/12\/12\/fbi-agents-raid-autism-treatment-centers-in-minnesota\">FBI raided two providers<\/a> late last year as part of an investigation into Medicaid fraud.<\/p>\n\n\n\n<p><strong>Families Fight Back<\/strong><\/p>\n\n\n\n<p>But efforts to rein in spending on the therapy have also triggered backlash from families who depend on it.<\/p>\n\n\n\n<p>In North Carolina, families of 21 children with autism filed a lawsuit challenging the 10% provider payment cut. In Colorado, a group of providers and parents is <a href=\"https:\/\/www.denverpost.com\/2025\/10\/01\/autism-therapy-colorado-lawsuit-medicaid\/?clearUserState=true\">suing the state<\/a> over its move to require prior authorization and reduce reimbursement rates for the therapy.<\/p>\n\n\n\n<p>And in Nebraska, families and advocates say cuts of the magnitude the state implemented \u2014 from 28% to 79%, depending on the service \u2014 could jeopardize their access to the treatment.<\/p>\n\n\n\n<p>\u201cThey\u2019re scared that they\u2019ve had this access, their children have made great progress, and now the rug is being yanked out from under them,\u201d said Cathy Martinez, president of the <a href=\"https:\/\/www.autismfamilynetwork.org\/copy-of-afn-board\">Autism Family Network<\/a>, a nonprofit in Lincoln, Nebraska, that supports autistic people and their families.<\/p>\n\n\n\n<p>Martinez spent years advocating for Nebraska to mandate coverage of ABA therapy after her family went bankrupt paying out-of-pocket for the treatment for her son Jake. He was diagnosed with autism as a 2-year-old in 2005 and began ABA therapy in 2006, which Martinez credited with helping him learn to read, write, use an assistive communication device, and use the bathroom.<\/p>\n\n\n\n<p>To pay for the $60,000-a-year treatment, Martinez said, her family borrowed money from a relative and took out a second mortgage before ultimately filing for bankruptcy.<\/p>\n\n\n\n<p>\u201cI was very angry that my family had to file bankruptcy in order to provide our son with something that every doctor that he saw recommended,\u201d Martinez said. \u201cNo family should have to choose between bankruptcy and helping their child.\u201d<\/p>\n\n\n\n<p>Nebraska mandated insurance coverage for autism services in 2014. Now, Martinez worries the state\u2019s rate cuts could prompt providers to pull out, limiting the access she fought hard to win.<\/p>\n\n\n\n<p>Her fears appeared substantiated in late September when Above and Beyond Therapy, one of the largest ABA service providers in Nebraska, notified families it planned to terminate its participation in Nebraska\u2019s Medicaid program, citing the provider rate cuts.<\/p>\n\n\n\n<p>Above and Beyond&#8217;s website advertises services in at least eight states. The company was paid more than $28.5 million by Nebraska\u2019s Medicaid managed-care program in 2024, according to a <a href=\"https:\/\/auditors.nebraska.gov\/APA_Reports\/2025\/SA25-09232025-January_1_2023_through_December_31_2024_Applied_Behavior_Analysis_Attestation_Report.pdf\">state audit<\/a>. That was about a third of the program\u2019s total spending on the therapy that year and four times as much as the next largest provider. CEO Matt Rokowsky did not respond to multiple interview requests.<\/p>\n\n\n\n<p>A week after announcing it would stop participating in Nebraska Medicaid, the company reversed course, citing a \u201ctremendous outpouring of calls, emails, and heartfelt messages\u201d in a letter to families.<\/p>\n\n\n\n<p>Danielle Westman, whose 15-year-old son, Caleb, receives 10 hours of at-home ABA services a week from Above and Beyond, was relieved by the announcement. Caleb is semiverbal and has a history of wandering away from caregivers.<\/p>\n\n\n\n<p>\u201cI won&#8217;t go to any other company,\u201d Westman said. \u201cA lot of other ABA companies want us to go to a center during normal business hours. My son has a lot of anxiety, high anxiety, so being at home in his safe area has been amazing.\u201d<\/p>\n\n\n\n<p>Nebraska officials <a href=\"https:\/\/nebraskaexaminer.com\/2025\/07\/18\/advocates-fear-for-autistic-nebraska-youths-as-cuts-come-to-medicaid-reimbursement-rates\/\">have said<\/a> the state previously had the highest Medicaid reimbursement rates for ABA in the nation and that the new rates still compare favorably to neighboring states\u2019 <a href=\"https:\/\/dhhs.ne.gov\/Pages\/DHHS-Gives-Update-on-Medicaid-Rate-Adjustments-Sets-Record-Straight-on-Misinformation.aspx\">but will ensure<\/a> the services are \u201cavailable and sustainable going forward.\u201d<\/p>\n\n\n\n<p><strong>States Struggle With High Spending<\/strong><\/p>\n\n\n\n<p>State Medicaid Director <a href=\"https:\/\/dhhs.ne.gov\/Pages\/Biography-MLTC.aspx\">Drew Gonshorowski<\/a> said his agency is closely tracking fallout. Deputy Director <a href=\"https:\/\/www.linkedin.com\/in\/matthew-ahern-mba-mha-1865163\/\">Matthew Ahern<\/a> said that while no ABA providers have left the state following the cuts, one provider stopped taking Medicaid payments for the therapy. New providers have also entered Nebraska since officials announced the cuts.<\/p>\n\n\n\n<p>One Nebraska ABA provider has even applauded the rate cuts. Corey Cohrs, CEO of <a href=\"https:\/\/radicalmindsomaha.com\/\">Radical Minds<\/a>, which has seven locations in the Omaha area, has been critical of what he sees as an overemphasis by some ABA providers on providing a blanket 40 hours of services per child per week. He likened it to prescribing chemotherapy to every cancer patient, regardless of severity, because it\u2019s the most expensive.<\/p>\n\n\n\n<p>\u201cYou can then, as a result, make more money per patient and you&#8217;re not using clinical decision-making to determine what&#8217;s the right path,\u201d Cohrs said.<\/p>\n\n\n\n<figure class=\"wp-block-image alignwide size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"3840\" height=\"2560\" src=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg\" alt=\"A 3-year-old girl holds a baby doll.\" class=\"wp-image-2125534\" srcset=\"https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg 3840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=150,100 150w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=500,333 500w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=768,512 768w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=1270,847 1270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=1536,1024 1536w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=2048,1365 2048w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=770,513 770w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=840,560 840w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=720,480 720w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=570,380 570w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=370,247 370w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=270,180 270w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=170,113 170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=100,67 100w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=120,80 120w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=1170,780 1170w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=300,200 300w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=200,134 200w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=315,210 315w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=630,420 630w, https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/2\/2025\/12\/Autism-Medicaid_Osborne_01.jpg?resize=1200,800 1200w\" sizes=\"auto, (max-width: 3840px) 100vw, 3840px\" \/><figcaption class=\"wp-element-caption\">The therapy is designed to help clients improve communication and social interactions. Aubreigh has since notched a series of firsts, including making a best friend.<span class=\"photo-credit\">(Katie Linsky Shaw for KFF Health News)<\/span><\/figcaption><\/figure>\n\n\n\n<p>Nebraska put a <a href=\"https:\/\/nebraskaexaminer.com\/2025\/01\/31\/dhhs-issues-guardrails-for-serving-nebraska-kids-with-autism-as-medicaid-costs-surge-audits-loom\/\">30 hour-a-week cap<\/a> on the services without additional review, and the new rates are workable for providers, Cohrs said, unless their business model is overly predicated on high Medicaid rates.<\/p>\n\n\n\n<p>In North Carolina, Aubreigh Osborne\u2019s ABA services were restored largely due to her mother\u2019s persistence in calling person after person in the state\u2019s Medicaid system to make the case for her daughter\u2019s care.<\/p>\n\n\n\n<p>And for the time being, Gaile Osborne won\u2019t have to worry about the legislative squabbles affecting her daughter\u2019s care. In early December, North Carolina Gov. Josh Stein canceled all the Medicaid cuts enacted in October, citing lawsuits like the one brought by families of children with autism.<\/p>\n\n\n\n<p>&#8220;DHHS can read the writing on the wall,\u201d <a href=\"https:\/\/www.youtube.com\/live\/-M05Pqm2XFc?si=ihW09aLLuvm7yRFN&amp;t=215\">Stein said<\/a>, announcing the state health department&#8217;s reversal. \u201cThat\u2019s what\u2019s changed. Here\u2019s what has not changed. Medicaid still does not have enough money to get through the rest of the budget year.\u201d<\/p>\n\n\n\n<p>Osborne is executive director of Foster Family Alliance, a prominent foster care advocacy organization in the state, and taught special education for nearly 20 years. Despite her experience, she didn\u2019t know how to help Aubreigh improve socially. Initially skeptical about ABA, she now sees it as a bridge to her daughter\u2019s well-being.<\/p>\n\n\n\n<p>\u201cIt\u2019s not perfect,\u201d Osborne said. \u201cBut the growth in under a year is just unreal.\u201d<\/p>\n\n\n\n<p><em>Do you have an experience with cuts to autism services that you\u2019d like to share? <a href=\"https:\/\/kffhealthnews.org\/share-your-autism-services-story-with-us\/\">Click here<\/a> to tell KFF Health News your story.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>States facing yawning budget shortfalls have begun cutting Medicaid reimbursements for a wide variety of services. 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