Advocates push MassHealth to cover ABA and essential therapies for adults with autism

The Joint Committee on Healthcare Financing heard testimony July 4 from parents, advocates and disability organizations urging MassHealth to extend coverage of applied behavior analysis (ABA) and other medically necessary services to adults with autism and intellectual and developmental disabilities (House Bill 1351 / Senate Bill 871).

Why it matters: advocates said ABA and other interventions are medically necessary for many adults with profound autism and that terminating coverage at age 21 creates a “cliff” that can lead to regression, emergency placements and higher state costs. Mara Sullivan, CEO of The Arc of Massachusetts, summarized the sponsors’ request: “Simply put this bill requires MassHealth to cover applied behavior analysis ABA for people with autism or intellectual and developmental disabilities over the age of 21 as private insurance already does.”

Testimony highlights: family members described concrete examples of skill loss and increased safety risks when services end at 21. Herb Cabral, a parent who has testified on this issue for years, described long-term gains from ABA for his son and warned that withdrawing services risks skill erosion. Josh Gladstone of the Massachusetts Developmental Disabilities Council emphasized that workforce shortages compound the problem: when day programs and provider capacity collapse, adults lose supports they previously relied on.

Costs and data: witnesses cited a 2023 autism commission report and pilot program data. The commission’s report included an estimate used in testimony that reflected average costs for services in a narrow age band; proponents also shared pilot results showing reduced maladaptive behaviors and said a CHIA cost study would be appropriate for legislative consideration. Advocates suggested looking at private insurance spending and pilot data to model MassHealth costs and potential offsets from avoiding crisis placements.

Discussion vs. action: the hearing recorded testimony only; no votes were taken. Committee members asked about population size and cost estimates; advocates offered program data and urged the committee to commission formal fiscal analysis where appropriate.

Next steps: advocates urged a favorable report and recommended further study and cost modeling by the committee or by state analytic agencies to quantify fiscal impacts. The committee remains open to written testimony through the deadline stated at the hearing.