New York Budget Proposal Cuts Essential Autism Services

My wife Susie startled me with a question the other week as she scrolled through a WhatsApp chat group for parents of children with autism spectrum disorder.

"Hey, Michael," she said, "did you see where your Syracuse classmate is targeting autism services for cuts?"

Alarmed parents in the group had learned that Gov. Kathy Hochul's massive 2026 budget proposal -- which aims to increase state spending by $19 billion, or 8.3% -- includes one outrageous cut: It will slice state spending on Medicaid payments for a behavior therapy helpful to our children.

For parents of autistic kids, the specter of their stimming or "melting down" in a store, restaurant or family gathering can be mortifying.

Stimming -- repetitive behaviors like rocking, hand flapping, vocalizations or, in our oldest boy's case, spitting -- is common among autistic children and adults, often as a means of relieving stress or sensory overload.

A proven intervention therapy called Applied Behavior Analysis effectively helps to ameliorate or end those behaviors -- and now it's in Albany's crosshairs.

ABA is an evidenced-based individualized therapy that rewards desired behaviors to increase their frequency, while reducing vexing conduct like tantrums or self-injury. The process improves daily living skills and furthers academic development.

Licensed behavior analysts and certified behavior analyst assistants must meet the State Education Department's strict training requirements and standards.

Fortunately for many families, including ours, private insurance covers the cost of ABA therapy.

But for needy families who rely on public health-care programs, partial Medicaid coverage for ABA only began in 2021, and full coverage didn't start until 2023.

Without Medicaid coverage for ABA, low-income families will have no way to afford this essential service.

It's a relatively tiny fraction of the state's massive $35 billion Medicaid budget for next year, much less of the gargantuan $252 billion state budget Hochul has proposed.

Yet "New York's first mom governor" wants to lop off $30 million over two years from a small program serving vulnerable, low-income autistic kids and their families as a cost-saving measure.

Yes, Medicaid spending is on an unsustainable trajectory (a 36% jump during Hochul's first three years as governor). But those costs aren't being driven by autism services.

The chief beneficiaries of New York's Medicaid spending are hospitals and the state's largest health-care union, 1199 SEIU, both of which will launch seven-figure attack ads if the governor even hints at cutting the state-run health plan.

Hochul's spending plan hikes reimbursement rates for hospitals, nursing homes and other providers -- whose workers just happen to be 1199 SEIU members -- while cutting rates for autism therapists, who aren't unionized.

On Feb. 7, Hochul visited Rochester for a "conversation" with mothers about her "affordability agenda," which she's been touting as a boon to middle-class families who have been fleeing New York's steep taxes and high cost of living.

I know a number of low-income autism moms who're itching to chat with Kathy and her brain trust about why her Medicaid penny-pinching must come at their expense, and that of their children.

One of those mothers, Michelle P., explained to me what she'd tell Hochul about the services now on the chopping block.

"The ABA therapists have helped [my child] with stimming, elopement, meltdowns, learning to play appropriately and substituting maladaptive behaviors," Michelle texted.

If Hochul were serious about Medicaid savings, she'd heed the latest audit from state Comptroller Tom DiNapoli, which revealed that the Department of Health improperly paid $16.2 million in claims during a 6-month period.

Heck, that's over $32 million a year in fraudulent or erroneous spending -- more than enough to cover Medicaid ABA services.

Attaboy, Tommy, you've earned the gratitude of the autism community.

There's plenty more fraud, waste, abuse and mismanagement in the state's Medicaid system.

Cracking down on that would recoup hundreds of millions of dollars to pay for invaluable autism services -- and still achieve significant savings.

So what do you say, Governor? Are you willing to rescind a proposed cut that will only increase the burdens, anxieties and discomfort of low-income families and their autistic children?

Take it from your old college schoolmate: Don't harm children on the autism spectrum for fear of union blowback.