Special needs kids may benefit from Obamacare due to the requirement for insurers to provide habilitation as well as rehabilitation services. Rehabilitation services help restore skills to people who may have lost the skills due to an accident or illness, while habilitation services teach basic living skills to kids and people who need extra help in achieving life skills that others often learn with little effort. Speech therapy for kids with cerebral palsy is an example of habilitation therapy and, in the past, some insurers have argued it is an education issue not a medical one.
The law allows individual states to identify what services are essential health benefits and New York State requires that habilitation services are comparable to rehabilitation services, but the requirement of post operative or surgical treatment required for rehabilitative services is not required for habilitation.
Strong advocacy from groups such as Autism Speaks has resulted in private insurers covering applied behavior analysis but advocates have concerns about the coverage private insurers will provide. Medicaid covers habilitation services but some individuals say it is difficult to find out what habilitation services are included under private policies. Again, time will tell how well Obamacare will cover these needed services for special needs kids.
Questions or comments? Contact Pat Wright.