A military family in Nevada is fighting to secure TRICARE coverage for applied behavior analysis therapy for their autistic son.
This struggle highlights a growing disparity between military and civilian healthcare, where families of service members may lack access to standard autism treatments. The outcome of these disputes could determine whether thousands of children across several states maintain their developmental support.
Kristi Cabiao, a military parent, is leading the effort to challenge the restrictions placed on applied behavior analysis, also known as ABA therapy. While many civilian insurers cover the treatment, TRICARE restricts its availability [1]. This gap in coverage forces families to seek alternative funding or face significant financial burdens to ensure their children receive necessary care.
The impact of these coverage limitations is being felt across the Southwest. In Nevada, families may face thousands of dollars in out-of-pocket costs due to coverage cuts [2]. The situation extends beyond state lines, as approximately 1,000 children in Arizona could lose access to ABA therapy if current coverage changes proceed [3].
Advocates said that a lack of formal complaints often hinders the broader fight against these coverage cuts [2]. Without a documented trail of denials and appeals, it remains difficult for policymakers to quantify the scale of the issue or the number of families affected by the military plan's restrictions.
Cabiao and other advocates are calling for TRICARE to align its policies with civilian insurance standards to ensure that military children are not penalized for their parents' service. The fight centers on the necessity of ABA therapy in managing autism, and the long-term developmental risks associated with interrupted treatment.
“TRICARE restricts coverage of ABA therapy even though many civilian insurers cover it.”
The disparity between TRICARE and civilian insurance regarding ABA therapy creates a systemic gap in care for military dependents. If the military health system does not modernize its coverage to match private sector standards, it may lead to a regional crisis in autism services, particularly in states like Nevada and Arizona where out-of-pocket costs are prohibitive for many families.
