Changes to insurance qualifications for certain types of healthcare by the Trump administration have made it more difficult for providers looking to help families learn to live with autism to provide their services to those most in need, an advocacy group told Newsweek.
President Donald Trump returned to office last year on a promise to cut costs at the federal level, pushing through the One Big Beautiful Bill (OBBB) in order to enact wholesale changes to various departments and agencies, including qualifications for Medicaid, which many low-income families rely on. The Center on Budget and Policy Priorities (CBPP), a Washington D.C.-based think tank, last year determined around 70 million people with low incomes received their healthcare coverage through Medicaid as of June 2025.
Newsweek reached out to Health and Human Services (HHS) by submission form last week for comment, as well as other advocacy groups Autism Speaks and the Autism Society by submission form and email.
Autism as a condition has no clear or singular approach for support, leaving families often at odds about what they can do when they see their child struggling. The clampdown on qualification for support can restrict those options or outright make them unviable.
“A lot of provider groups rely heavily on Medicaid funding because there are so many of the children that need the services that we provide that have Medicaid as their primary insurance holder, either because of income limitations or because they’re on waivers for disabilities,” Pinny Berger, president of the Autism Families Alliance, told Newsweek.
Kate Koble, regional clinical director at Golden Steps ABA, said she had seen “a ton of changes within insurance requirements” over the years, each time seeing them “get more strict as time goes on.”
The new changes make it harder to qualify for the funding needed to provide therapy and support for children learning to live with autism, she said.
“It goes all the into the data that we have to provide for insurance and timelines of… taking that and putting it into a report, like they’re even making that shorter so we have less time to prepare it for insurance companies,” Koble said. “So as time’s gone by, there’s just more and more hoops to jump through in restrictions that we have to prove.”
How State-Level Restrictions Complicate Care
Agencies like Golden Steps ABA, which focuses on Applied Behavior Analysis (ABA), operate across a number of states, and changes introduced in the OBBB can also hit compensation rates depending on where clinicians operate.
This makes the issue not just a federal restriction but also shows some of the state-side policy changes have only added more pressure to an already delicate situation. Oklahoma, for instance, added a restriction of 50 miles from the state’s borders to allow residents to seek medical resources in another state, such as ABA therapy.
And it also hits where providers and clinicians move in order to receive appropriate compensation, with rates varying significantly enough from state-to-state to impact where they settle and what kind of pool of talent various groups and centers can pull.
“I’m in Fort Wayne, Indiana, which is along the Ohio border, and because of reimbursement rates that are different in Indiana and Ohio, we have many BCBAs [Board Certified Behavior Analysts] from Ohio traveling into Indiana just to be compensated fairly,” Koble said, which has left Ohio with “minimal clinicians, and families are struggling to find services.”
Golden Steps ABA functions in states like Indiana, Oklahoma, Nebraska, North Carolina, Virginia, Arizona, Utah, Massachusetts, and Maryland, while looking to expand into others, which means they largely operate in states that voted for Trump and Republicans.
“There is shortages of behavior analysts in specific areas of the country. So that’s definitely a factor,” Berger said. “In terms of what parents can do, it’s really, from an advocacy perspective, I think there’s room for parents to be involved.”
“What we have been doing as part of our autism families alliance is trying to create some sort of a grassroots movement for families to advocate for themselves to their local politicians,” Berger added. “There are so many people in that they themselves have been impacted by autism in their lives.”
Trump Administration’s Focus on Autism
The Trump administration has made autism an outsized focus during its overhaul of the nation’s healthcare system, with HHS Secretary Robert F. Kennedy Jr. launching an effort to determine the “cause” of what he termed the “autism epidemic.”
Kennedy Jr., who has pledged to “Make America Healthy Again,” has frequently spread health misinformation, including claims linking vaccines to autism, a connection that has been widely discredited by scientific research.
“The autism rates have gone from—our most recent numbers we think are going to be about 1 in 31, so they are going up again, from 1 in 10,000 when I was a kid,” the health secretary previously said.
According to the Centers for Disease Control and Prevention (CDC), 1 in 36 children have been identified with autism spectrum disorder (ASD). Its data going back to 2000 reported that 1 in 150 children was diagnosed with autism.
However, Dr. Alex Kolevzon, clinical director of Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, previously told Newsweek the increase in autism diagnosis is partially due to “new iteration[s] of the diagnostic manual,” with the diagnostic criteria “steadily” broadening.
Ultimately, Kennedy Jr. announced the administration had linked autism to the use of acetaminophen, the active ingredient in Tylenol, by pregnant mothers. Authors of the study that Kennedy Jr. leaned on for his determination warned however that “we obviously need more definitive studies than we have, but what we do know is acetaminophen has many of the hallmarks of an environmental toxicant.”
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