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If you’re raising a child with autism, you probably understand that progress takes time, patience, and the proper support. That’s why the recent Indiana’s new rule capping ABA therapy at just 36 months for a child’s entire life just feels off to many parents whose loved ones are on the spectrum.

The policy, now in effect as of April 1, 2025, limits Medicaid-covered ABA therapy to three years total, no matter when your child starts or how long they need it. After that, only “focused ABA” will be covered, targeting one or two specific behaviors. Even then, it must be deemed “medically necessary.”

Why the Policy Was Introduced

This change is part of a broader overhaul of Medicaid. State officials say the goal is to rein in spending and crack down on fraud. And yes, there have been real issues. Costs jumped from $120 million in 2019 to over $630 million by 2023. Investigations revealed serious problems: providers billing for therapy that never happened, undertrained staff, and even charges for sessions while kids were asleep.

However, instead of targeting the bad actors, the state responded with a blanket policy, penalizing everyone, including high-quality providers and the families who rely on them.

Autism doesn’t run on a schedule. Some children require intensive help during their toddler years. Others don’t show major struggles until school starts or adolescence hits. A one-size-fits-all limit ignores the way autism works—and how kids grow.

The Role of Early and Ongoing Support

Ophelia Weir, director of Indiana Full Spectrum Therapy, gets it. She knows the field isn’t perfect. But she’s also seen firsthand what good therapy can do: a child saying “Mom” for the first time, learning to self-soothe, sitting through a haircut without a meltdown. These are breakthroughs that can’t be rushed—and indeed shouldn’t be rationed by a countdown clock.

Rep. Becky Cash of Zionsville tried to intervene with HB 1414, a bill that would’ve paused the cap until a proper study could be done. It didn’t pass. Now, families currently receiving therapy are covered until April 1, 2028—but once those 36 months are up, that’s it.

This isn’t just a policy shift. It’s a blow to early intervention. The first five years of life are critical for brain development—language, emotional regulation, and problem-solving. Some kids may thrive after a year or two of therapy. Others, especially those with complex needs, require longer-term support. Cutting that off prematurely risks long-term setbacks.

There’s also the economic toll. Many parents depend on ABA not just for treatment, but for childcare so they can work. Losing coverage could force some families into unemployment or financial crisis. And the state’s proposed alternative—the Medicaid waiver for paid family caregiving—has a years-long waitlist.

How This Affects Children, Families, and Providers

Indiana’s push for reform may come from a place of fiscal caution, but its approach sacrifices clinical flexibility and family stability. Over 7,000 children currently rely on ABA in the state. That number is expected to grow. Tying care to an arbitrary cap won’t solve the system’s problems—it just creates new ones.

Families need oversight, yes—but also compassion, nuance, and policies that reflect the realities of autism. Our kids deserve better than a ticking clock.

If you have questions about ABA therapy, your rights, or next steps, contact us at Illinois Autism. We’re here to help you navigate the changes, advocate for your child, and keep the support going.