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Noem Can Claim Credit for Autism Coverage Thanks to Obama Compromise on ACA

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.


  1. Donald Pay 2019-10-12 08:41

    Noem is evil and self-centered, characteristics we’ve seen with her bullying of the Girls Stater for taking a picture of her. Sometimes those characteristics, though, make her do the right thing. If it’s in her interest to appear kind to autistic children and their families, Noem is enough different from Donald Trump to at least pretend a minimal empathy and pretend to mean it by changing policy. She calculated a political self-interest. That’s Noem’s kind of empathy. You point out the she would celebrate a court case that would strip those benefits away, even before they get implemented. That’s not hypocrisy. That’s evil.

  2. grudznick 2019-10-12 10:35

    Good on Governor Noem, and good on Mr. President Obama too. This just goes to show what polite working across the isle can do. They used to think grudznick was on the spectrum but it turned out to be something different.

  3. Donald Pay 2019-10-12 11:21

    Good on Governor Noem? Well, sure, we can all agree she finally did the right thing for those families. But don’t fall for the con, Grudz. When she comes out and opposes taking away the same coverage through South Dakota state government joining the lawsuit to strike down what she just gave, that’s when I’ll believe she’s “working across the isle” (sic). I’d call what Grudz is working across as fantasy isle.

  4. Jenny 2019-10-12 13:40

    Donald, that doesn’t really sound like you to say that Noem is evil. She is just your typical flaky mean girl that loves the spotlight on her, is very self-absorbed and self-entitled, but even I don’t think Noem is evil. She is definetly a narcisist and is obsessed with being Christian (who knows if that is just an act) prolife and loving God and so that is why ignorant, uneducated South Dakotans voted for her. All you have to have is Republican, Christian and pro-life behind your name and you’re in very easy position to win in South Dakota.

    South Dakotans are too vulnerable to think outside the box to ever consider other candidates. They just can’t do it, this is a very real and deep phobia they suffer from. I believe there are actually some rebublicans that are in the closet and more progressive than they would ever let on, but are too scared to show their true beliefs, because of the ostracism they would receive.

    The Republican Party is a cult in South Dakota and a boring dumbed down mean one at that. They have no desire to learn and educate themselves on any other number of issues, including other cultures. They believe that dark-skinned immigrants from other countries are terrorists out to get them. They struggle with empathy towards anyone that looks slightly different from them. They really do want to stay in the 1950s. It’s all rather sad since SD is my home state and so many good people left because they just coudn’t take the narrow-mindedness anymore.

    Then there is the LGBTQ, the hatred towards them is astounding, even though there are plenty of cowboys that are closet homosexuals. Brokeback Mountain happens more frequently than any South Dakotan would ever know. It is terribly heartbreaking how fast So Dakotans would disown a farmer whose family has owned their land for generations just because he is gay. Is this really the kind of state you want, SD? Sad to say, it is.

  5. Robin Friday 2019-10-12 15:36

    Jenny, so well said. Especially the part about outside the box.

  6. Debbo 2019-10-12 18:12

    Yup. That’s SD. So much potential pushed away. 😥

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