SAN ANTONIO – We were the first to tell you about issues with the military health program, Tricare. Now a congressional committee is also calling for changes to benefits for people living with autism.

A new study shows the old way of coverage isn’t working.

Families could be near the end of their battle for effective healthcare coverage. The Defense Health Agency (DHA) could soon make changes to the way some military families get autism therapy services they need.

“There were a lot of hoops to jump through,” said military spouse Rebecca Brown.

Her 6-year-old daughter is autistic and needs Applied Behavioral Analysis (ABA). It’s a type of therapy specifically tailored to her needs; right now, it’s not the easiest to get enrolled in.

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“In the Autism Care Demonstration (ACD), there are different assessments that we’re required to complete — both the families and the ABA therapy providers,” Brown said.

The ACD program has been around since 2014. Brown said she’s faced struggles since learning of her daughter’s diagnosis.

“Every three months I was spending, no joke, about eight hours on the computer going through each of these and there wasn’t any change in the services that my daughter received based on the outcomes of those tests,” Brown said.

“Autism care services have really evolved over the last 10 years. We need to evolve and be dynamic along with it,” said Eric Flake, an developmental behavioral pediatrician.

In 2023, Congress called for recommendations on how to better serve military families with an autism diagnosis as part of the National Defense Authorization act. The National Academy of Science published those recommendations this month, Eric Flake was on the committee commissioned by the DHA to write them.

“One of the things that we did recognize is that there is enough evidence at this time to now move it from a demonstration to a basic benefit,” Flake said. “We think that that’s a timely recommendation.”

That means, instead of going through the ‘hoops’ Rebecca described, families can get a referral from a doctor and go straight to an ABA specialist. In the report, the committee said the ACD “lags behind current clinical science and best practices”, calling for ABA to becoming a basic Tricare benefit.

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“The requirement to do all these extra things when we know that we need access to this service was just a huge barrier for families like mine,” Brown said.

Now, congress has a decision to make.

“We are hopeful and excited that the Defense Health Agency, that nonprofit organizations, that congress who asked us to put this together will look at the recommendations and act,” Flake said.

“This panel, that DoD commissioned themselves, has given them the results that it is effective,” Brown said. “It should be covered..we should get that change done, and — done quickly.”

We reached out to the DHA for comment about those recommendations. Their team sent us a statement saying they’re carefully reviewing the entire report to determine their way forward with the ACD program. Until they finish their review, DHA will keep their services under the ACD program.

We’ll keep you updated in their final decision.

Full DHA Statement

“We just received the Comprehensive Autism Care Demonstration report conducted by the National Academies of Sciences, Engineering and Medicine (NASEM). We are carefully reviewing the entire report, including the recommendations, to determine our way forward with the Autism Care Demonstration (ACD) Until this review is completed, the Department will continue to provide the services available under the ACD.”