Alexander, N.C. — In a heartwarming transformation, three-year-old Aubreigh Osborne is forging friendships and finding joy in play, a stark contrast to the struggles she faced just months ago. Diagnosed with autism at 14 months, Aubreigh’s family had to navigate a challenging landscape of therapy and behavioral outbursts before engaging with a new approach that fostered significant growth.

Her adoptive mother, Gaile Osborne, remembers a time when outings felt overwhelming due to Aubreigh’s difficulties with social interactions. “Just a few months ago, I didn’t expect her to make friends at school,” Gaile said, noting how Aubreigh has blossomed since starting applied behavior analysis (ABA) therapy this summer. This evidence-based treatment has proven effective in improving communication and social skills for many children diagnosed with autism.

Initially, Aubreigh struggled with managing her emotions, sometimes leading to self-harming behavior, which kept the family at home, avoiding public situations. A technician trained in ABA now visits their home five days a week, working closely with Aubreigh, who has already started preschool, embraced toilet training, and even enjoyed family grocery outings. “That’s what ABA is giving us: moments of normalcy,” Gaile said.

Despite these advances, Aubreigh’s access to therapy faced a severe setback. In October, state budget cuts led to a significant reduction in her weekly therapy hours from 30 to 15, highlighting a troubling trend affecting numerous families across the country. As state programs make budgetary adjustments, several Medicaid programs, including North Carolina’s, have proposed steep cuts to ABA payment rates.

In recent years, many states have witnessed soaring costs associated with autism therapy; North Carolina’s Medicaid payments for ABA are projected to escalate from $122 million in 2022 to $639 million by 2026. Nebraska reported a staggering increase in spending, with some services seeing up to a 1,700% rise in costs. This financial strain has triggered states to reconsider how much they allocate for such essential services.

Mariel Fernandez, a representative from the Council of Autism Service Providers, pointed out that the growing awareness and diagnosis of autism are resulting in increased demand for ABA therapy. While the treatment is critical, the recent cuts indicate a troubling struggle to balance budget constraints with the need for adequate health services. Medicaid coverage for autism treatments only began in earnest in 2022, leaving many families in precarious positions as they navigate these new challenges.

The cuts have sparked outrage among families who rely on these services. In North Carolina, parents have initiated legal action against the state, advocating for fair access to necessary therapy. Similar backlash has been observed in Colorado and Nebraska, where families express fears over the sustainability of their children’s treatment and future progress.

Cathy Martinez from Nebraska, who fought for autism coverage after facing bankruptcy due to her son’s therapy costs, encapsulated the anxiety shared by many families. “They’re scared that they’ve had this access, their children have made great progress, and now the rug is being pulled out from under them,” she said.

In the wake of public outcry, North Carolina Governor Josh Stein recently reversed the cuts, acknowledging the urgent necessity for autism services. “DHHS can read the writing on the wall,” Stein remarked, underlining the critical nature of ongoing advocacy efforts. For now, Aubreigh’s therapy is secure, providing her family with hope as they continue to witness her remarkable progress.

Despite the challenges they face, families like the Osbornes remain dedicated to supporting their children’s development through available resources. “It’s not perfect,” Gaile noted, “but the growth in under a year is just unreal.”