In 2008, Barack Obama promised to mandate insurance coverage for autism treatment. But among his many olive branches to the opposition party (who were already getting an olive tree in the form of President Obama’s embrace of Romneycare instead of single-payer or the public option) was a compromise leaving it up to states to decide whether autism services like applied behavior analysis (ABA) ought to be included among the essential health benefits that have to be included in benchmark insurance plans. Most states chose to mandate that ABA coverage. President Obama’s Affordable Care Act (ACA) eliminated copays for autism screening in well-chld visits, and families dealing with autism benefited further from the ACA’s protection against denial of coverage due to pre-existing conditions and provision for young adults to remain on parents’ insurance until age 26.
After trying in Congress to take the ACA and health insurance away from families dealing with autism, and after letting die last February a bill that would have mandated autism coverage in South Dakota, Governor Kristi Noem is now using the state flexibility provided under the ACA to do what President Obama really wanted and provide insurance for ABA. In July, the state Division of Insurance added an ABA mandate to ACA marketplace plans in South Dakota starting in 2021. Now Governor Noem has apparently coaxed our two biggest insurers, Sanford and Avera, to resume covering ABA a year earlier, in their 2020 policies. (Sanford and Avera dropped that coverage earlier this year, because, you know, money’s tight, and Sanford needs to sponsor cage-fighting.)
To avail themselves of tehe generosity Governor Noem has apparently squeezed from Sanford and Avera, families need to enroll in the ACA marketplace during the Trump-shrunken window from November 1 to December 15.
But remember, while Governor Noem claims credit Obama-style reforms that she fought endlessly in Washington, her beloved Donald Trump and our Attorney General are asking the courts to take that autism coverage and everything else good brought by the Affordable Care Act away from all Americans.