Pentagon Threatens Cuts to Families Dealing with Autism

The Pentagon is considering cutting funding for treatment of Autistic children in half.  This action, if taken, could devastate families like mine.

As part of the effort to cut defense department health costs, the Pentagon plans to slash provider reimbursements related to care for autistic children under TRICARE, the military’s healthcare plan.

The Tricare manual regarding provider reimbursements, released in September,  cuts autism care provider pay from $125 a hour to between $50 and $68 an hour.  As a beneficiary of these programs, I can vouch for the fact that, even before the proposed cuts, Tricare often is at the very low end of payments to providers.  I believe that medical professionals who accept Tricare patients are doing their part to help military families like mine, and I appreciate them.  The proposed cuts are an insult to the doctors  and therapists and a shot to the knees of military families faced with mounting costs of providing necessary treatments for our neurologically struggling kids.

Justifiably, many healthcare providers are balking at the pay cuts, because they won’t be able to provide their services at the lower rates. If the cuts go through, providers say the services will disappear.

Families will be forced to go without care or to seek out-of-network providers, at much higher rates.  By more than doubling the out of pocket medical costs for already struggling military families, the organization which is supposed to be looking out for its members is essentially cutting off essential care, thus stifling the development of our kids.

autism tricare 1

Early and continued therapies are essential to the progressive development of autistic children and young adults.  My son, Zack, has been getting supportive services since he was two years old.  He was basically non verbal until the age of four.  He struggled with putting pencil to paper and couldn’t throw a ball.  At 16, after years of speech therapy, social skills counseling and occupational therapy, Zack is doing remarkably, well.  He still struggles, every day, with many challenges related to his Autism Spectrum Disorder, including, but not nearly limited to: Dyslexia, Dysgraphia, Auditory Processing Disorder, Sensory Integration Disorder and Anxiety.  Thanks, though, to the continued care he has received for the past 14 years, through Tricare, he can manage them.  He carries on meaningful conversations with peers and adults; stays on track with his schedule, personal care and homework load; maintains very good grades at a highly intense independent overseas school, in Honors, IB and AP classes; and has a job tutoring math.

Without the care and education we have received from Tricare providers, the road would have been more bumpy and much longer.  If the Pentagon makes the financial cuts, over 1,200 children will see an immediate cut in their care.  These kids will suffer, not just in the short term, but in the long term as well.  Young autistic kids become autistic adults.  Therapies and treatments in childhood go a long way toward helping them develop into adults who can often live independent lives.  Kids left to flounder, without care, because their parents serve our country whose leaders cut their medical benefits, might suffer long term consequences and have to depend on other forms of more intense and costly care throughout their adult lives.

A Navigation Behavior Consulting survey of TRICARE providers who work with autistic children, found that 95 percent of these providers planned to cut back on the services they offer, while 22 percent intended to stop working with military children altogether, if the changes were to go through.

According to figures in Tricare documents, more than 7,800 military children received Autism related services in 2013.

Thanks, in part, to leaders such as Sen. Mark Warner (D-VA), the Pentagon has delayed the cuts until April, (which, ironically, is Autism Awareness month) but already some providers are seeing their reimbursements dwindling as a result of other changes to the system.  The Department of Defense and Congress need to hear from families and their supporters that the proposed cuts are not the way to save money in the defense department budget.

autism tricare 2

We cannot let these cuts go through next year.

If you agree that the cuts should be stopped, let the leadership know!

autism speaks 5k

About Commander in Chief At home

Erin is a military spouse and, sometimes temporarily single mom to 4 boys. She's a writer, editor, teacher, and (Autism) mom.
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2 Responses to Pentagon Threatens Cuts to Families Dealing with Autism

  1. Thank you for bringing more awareness to this topic! Sounds like your son is doing so great! 🙂

    I was a pediatric occupational therapist (before our overseas PCS) for six years. In six short years, Tricare’s reimbursement for pediatric therapy went from one of the best to one of the worst! 😦

    I’m guessing this is because some psychologists were prescribing ABA therapy. Some children were receiving 20-30 hours of ABA therapy every WEEK! I’m quite certain these hours were being charged the $100+ rate but the “therapy” was being provided by individuals who had minimal qualifications.

    Unfortunately, this abuse of insurance and the “healthcare crisis” is making Tricare do dramatic things to cut costs.

    For parents who have children who need therapy I encourage you to seek out help from non-profit organizations. There are several organizations who provide “scholarships” to families who can not afford therapy for their children. Best wishes!


  2. I just recently read this article…

    It appears to be as I assumed, in regards to ABA therapy. The many hours that the ABA assistant/technician provided were being reimbursed the $125/hour rate. Hopefully they will just differentiate the technician’s rate from the therapist’s rate.


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