For families with disabilities, navigating the complexities of healthcare has always been a challenge. With rising medical costs and the need for comprehensive support and coverage, many healthcare services were financially out of reach.
It seemed like a hopeless situation, until the advent of the Affordable Care Act (ACA). This revolutionary health insurance law has altered the fundamentals of healthcare in America. The ACA offers a wide range of benefits designed to provide financial relief, improve access to necessary services, and enhance overall quality of life.
The law has three primary goals:
- Make affordable health insurance available to more people.
- Expand the Medicaid program to cover all adults with income below 138% of the FPL.
- Support innovative medical care delivery methods designed to lower the overall costs of health care.
This lifesaving piece of legislation has ensured that essential health services are accessible to all Americans, including those with preexisting conditions. This has been a huge relief for numerous people previously denied coverage, enabling them to access services and significantly enhancing their quality of life.
For families with children who have Autism Spectrum Disorder (ASD), this means having coverage for vital services like Applied Behavior Analysis (ABA) therapy. ABA therapy is an evidence-based approach to improve specific behaviors, social skills, and communication. The ACA’s provisions help alleviate the financial burden of this and other therapeutic services.
Improved insurance coverage has provided significant relief for families by reducing their out-of-pocket expenses. This support provides stability, allowing families to allocate resources towards other crucial areas like education and care support. Telehealth services, expanded through similar policies, also allow increased access to services for many families, particularly those in remote areas. However, potential policy alterations could destabilize this delicate balance. If coverage limits are reinstated or if essential services face funding cuts, families could find themselves grappling with increased expenses and difficult choices.
Benefits of the Affordable Care Act
Preventive Services:
- The ACA goes beyond immediate healthcare needs by emphasizing preventive care. New health insurance plans are now required to cover preventive services without any cost-sharing. This includes autism screenings for children at 18 and 24 months, enabling early diagnosis and intervention, which are vital for improved long-term results.
Behavioral Health Treatment:
- The ACA has allowed for increased access for intensive behavioral health treatment programs, such as ABA. Recognized as an important part of autism treatment, intensive ABA, occupational, speech, physical, and social work therapy helps individuals to develop necessary life skills, manage behavior, and enhance communication. The coverage also extends to other behavioral health treatments, providing a more comprehensive approach to mental health care.
Elimination of Pre-existing Conditions:
- The ACA eliminated insurance companies’ ability to deny coverage due to pre-existing conditions. This means that a person can no longer be denied due to a diagnosis, lapse in coverage or other emergency medical needs. This is especially important for families with children diagnosed with autism as the diagnosis increases access to care rather than denying it.
We should not take the ACA for granted. The winds of political change can have a significant impact, bringing modifications that limit or remove coverage. We need to advocate for the ACA and not become complacent. It is crucial to communicate to legislators and politicians that policy changes in healthcare hold significant implications for families with disabilities. We must not go backwards and lose the hard-fought gains that are being implemented daily, enriching the quality of life for millions of Americans.
Challenges with the Affordable Care Act
Inconsistency in Plan Coverage:
- While the ACA has opened many doors for families with disabilities, the complexities of healthcare still present significant challenges. Some face difficulties communicating their needs or understanding their rights. Inconsistency in coverage across different plans is another common issue, which can lead to confusion and limited access to essential services.
Continued Need for Healthcare Literacy:
- There is also a belief that the healthcare provider’s representatives are trained to just say no. In fact, most of the time, they just don’t understand the services that you’re requesting. Don’t get discouraged. Ask for detailed explanations to why you were rejected. Keep a journal and write down all your communications. Change policies or add to your coverage. Take advantage of open enrollment periods to shop for plans and use a broker to fully understand the policy.
Confusing Policies and Rules:
- Health insurance brokers can simplify the often-overwhelming process of selecting the right insurance plan by providing essential information about various policy features, benefits, and potential costs. These licensed professionals serve as intermediaries between consumers and insurance providers, offering impartial guidance tailored to individual needs.
Why Advocacy Matters
Advocacy helps shape policies that directly impact the lives of people with disabilities. For example, policy influences funding for essential services that many rely on for daily living. It protects against discriminatory practices in healthcare and other sectors. Advocacy also promotes innovations in healthcare, such as the expansion of telehealth services, making care more accessible to those who need it.
Advocacy fosters community awareness and education, empowering families to navigate the complexities of the healthcare system effectively. By sharing personal stories and experiences, advocates can highlight the real-life implications of policy changes, galvanizing public support and urging policymakers to act. This collective effort not only safeguards the advances made under the Affordable Care Act but also paves the way for future improvements. Personal stories make the issues real and relatable, showing the human side of policy decisions and can be a powerful tool to garner public support.
Ongoing advocacy is vital for ensuring that all individuals with disabilities receive the care they deserve, contributing to their overall health and quality of life. By staying engaged and informed, we can continue to push for a more inclusive and equitable healthcare system for everyone.

Learn More About My Programs
Blue Bird Day is a rotational therapy program structured like a preschool or kindergarten, but instead of teachers all our staff are therapists! This program is designed to foster socialization, sensory regulation, and learning for children ages 2-7 and helps provide children the tools they need to succeed in a traditional classroom.
Eyas Landing is an outpatient therapy clinic that provides services for children ages 0-21. Our multidisciplinary team of therapists provide ABA, developmental, occupational, physical, speech, nutrition and feeding therapy along with early intervention, social work, counseling, and neuropsychological testing at our West Loop clinic, in-home, at school, and virtually.
Merlin Day Academy is a therapeutic day school for children ages 6-14. Our proprietary model utilizes daily therapeutic and educational rotations to support children’s growth, learning, and their transition into the least restrictive environment possible.