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Committee passes bill to let Medicaid cover applied behavior analysis for adults on CES waiver; fiscal range discussed
Summary
Senate Bill 311, which would expand Medicaid to cover applied behavior analysis services for adults on the CES waiver with autism, passed the committee after advocates’ testimony and a DHS fiscal presentation showing a wide cost range tied to enrollment scenarios.
Senators advanced Senate Bill 311, which would require Arkansas Medicaid to cover applied behavior analysis (ABA) therapy for adults enrolled in the Community and Employment Services (CES) waiver who have a diagnosis of autism, subject to federal approval where required.
Family members and advocates testified in support. Ron Cook described benefits his adult son received from ABA services and urged the committee to approve coverage beyond the current age limit. Sponsor and testimony emphasized that 42 states already provide some adult ABA coverage through Medicaid and that expanding coverage would support adults’ ability to live in the community, reduce emergency and acute care utilization, and lower long-term taxpayer costs by preventing institutional placements.
DHS officials explained the state must seek federal approval to add services to the CES waiver and that the bill’s structure directs the department to apply for the necessary waiver. DHS provided a fiscal-range estimate to the committee based on various enrollment assumptions: a graded range was presented, from a lower-end scenario (smaller number of clients) up to a broader scenario using the full pool of CES waiver participants with autism. The range DHS gave during the hearing placed the potential state share between approximately $3.6 million and $23.0 million depending on enrollment assumptions; DHS noted the larger figures assume broader participation and that final costs depend on federal approval and utilization patterns.
Committee members asked detailed questions about waiver mechanics, who would qualify, and the size of the affected population; DHS said children already receive ABA through fee-for-service Medicaid and that adults are not covered under current rules. After deliberation the committee adopted SB311 by voice vote and asked DHS to work on waiver applications and provide additional fiscal detail as the bill proceeds.
