Fight to Protect Access to Habilitation Under the ACA

A federal judge’s Dec.14 ruling that the Affordable Care Act (ACA) is unconstitutional and its provisions(such as essential health benefits and pre-existing condition protections) are invalid, complicates a regulatory scenario that already threatens consumers’access to habilitation and rehabilitation services. The judge did not,however, enjoin the law—meaning that the ACA is still the law. Whether this decision is ultimately upheld depends on the outcome of what is likely to be a lengthy appeals process that could end up at the U.S. Supreme Court. But habilitation and rehabilitation coverage is already threatened. The Centers for Medicare and Medicaid Services (CMS) issued regulations that give states greater flexibility in defining essential health benefits (EHBs) beginning in 2020 (see “ACA Plans May Reduce Therapy Coverage”) and allowing states to adjust the list of ACA-covered health care services. Changing coverage levels for habilitation and rehabilitation especially affect access to audiology and speech-language pathology services and devices. (Note: The ACA is a federal law, but states have the ability to implement and regulate it.) Historically, health insurers have covered rehabilitation, so payers understand that rehab helps a person re-establish lost or impaired skills. However, habilitation—a newer, less familiar benefit—helps a person establish skills they have not acquired at an age-appropriate level. Because the concept is newer...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Advocacy Audiology News Slider Speech-Language Pathology ACA affordable care act health care coverage public policy Source Type: blogs