California’s autism community suffered major setbacks last week in its efforts to gain access to autism treatment for all Californians. In a last-minute change, Governor Brown and the Legislature struck a budget deal for Medi-Cal funding which fell short of a previous attempt by Assemblymember John Perez (D-Los Angeles) and Senator Ed Hernandez (D-West Covina) that would have given Medi-Cal beneficiaries the same benefits as the essential health benefits in California’s health exchange. As a result, Medi-Cal enrollees will not have coverage for autism treatment services, better known as applied behavior analysis (ABA). While some Medi-Cal enrollees will have access to ABA through California’s regional centers, many children with autism spectrum disorder (ASD) do not meet the regional centers’ more stringent criteria.
In additional bad news, Governor Brown’s trailer bill proposal passed both houses with legislation intact that reduces current regional center support for autism families. As a result, beginning July 1, 2013, regional centers will no longer be allowed to pay any portion of a consumer’s health insurance deductible and will only pay co-pays and co-insurance for families whose income “does not exceed 400 percent of the federal poverty level.” Federal poverty level for a family of four is $23,550, so a family of four earning more than $94,200 a year will not be eligible for co-pay support, which costs families of children with ASD an average of $150-200 per week. Governor Brown’s legislation guts a critical piece of Senator Steinberg’s autism mandate, enacted in July of 2012, which continued to hold regional centers responsible for co-pays, co-insurance, and deductibles by reiterating the language in California’s Mental Health Parity Act.
California’s autism advocates, including FEAT and Children Now, have been vocal in their opposition to the trailer bill since Governor Brown first sent it to the legislature. Only in the last few weeks, though, did it become apparent that the legislature would let the bill pass through both houses unchanged. In addition to the elimination of co-pay, co-insurance, and deductible benefits, families who do qualify for co-pay support are likely to face substantial delays as regional centers complete means testing for thousands of California’s most vulnerable citizens.