Committee considers extending applied behavior analysis coverage under Medicaid

Senator Judy Lee (District 13) introduced Senate Bill 2190 to the House Human Services Committee, describing the bill as a request to expand coverage of applied behavior analysis (ABA) beyond the current age limit for some individuals with autism.

Why it matters: Supporters argued ABA can be effective beyond childhood for individuals with autism who continue to exhibit behaviors that impair daily living. Extending coverage would allow continued therapeutic intervention for those who meet medical necessity and qualification criteria under Medicaid.

Sen. Lee said the services are “quite effective” and recounted a family case where behavioral treatment and medication adjustments allowed a young adult on the autism spectrum to return home after residential treatment. She said the intent is to enable applied behavioral analysis to “continue working with the families and the individuals who are on the autism spectrum so that those behavioral issues could be addressed.”

Morris Hardy, director of the Dakota Central Human Service Zone and a member of the North Dakota Human Service Zone Association, testified in support and said the association backed the bill as an additional tool for foster- and in-home workers to better serve children and adults who need behavioral supports.

Department clarification and eligibility: Sarah Aker, executive director of the Division of Medical Services, answered committee questions about eligibility and scope. She confirmed the bill would apply to Medicaid (not private insurance) and explained that qualifying for Medicaid remains income- and asset-based for adults on waivers; in many cases individuals eligible for ABA would qualify through waivers such as the developmentally disabled waiver.

Where it stands: Committee members asked procedural and eligibility questions; no formal vote was recorded in the transcript.