American autism care providers who once supported the Trump administration's crackdown on Medicaid fraud are now warning that the effort to root out abuse has produced dangerous unintended consequences for some of the nation's most vulnerable children. The Autism Families Alliance, a national advocacy organization representing Applied Behavior Analysis providers and the families they serve, says a decision by Amerigroup — the insurer covering Georgia's foster children through Medicaid — to cut autism therapy reimbursement rates by 30% could leave many of those children without access to essential care.
The group says the reduction, which it attributes to broader federal and state efforts to combat fraud, threatens the financial viability of providers who treat foster children with autism. According to Taylor Sanders, a family advocate at the Autism Families Alliance, 75% of clinics will be forced to close their doors or stop serving foster kids because of the cuts. "It's scary to see that so many different things are being slashed in terms of Medicaid, and that we're seeing this drastic outcome," Sanders said. She emphasized that children with autism often need therapy to learn safety skills and manage aggressive or challenging behaviors, and that cutting provider pay undermines the entire system of care. "If we're not able to provide a good amount of pay to our providers, we're not able to make sure they're set up for success to be able to give some of these services, and we're going to see less and less children being able to access services at all," she added.
The warning marks a shift for the Autism Families Alliance, which in August publicly backed the Trump administration's Medicaid fraud crackdown, arguing that the alleged theft of millions of federal dollars had harmed both taxpayers and children with autism who rely on those services. The group supported eliminating fraud and prosecuting suspected criminals, but also cautioned that broad federal and state efforts could unintentionally make it harder for legitimate providers to care for children. Now, the coalition says Georgia's foster families are facing exactly the risk it previously raised. "I think fraud should be prosecuted by all means," Sanders said. "Anybody who is engaging in fraudulent behavior should be prosecuted to the highest extent of the law. Are we able to not only tackle the fraud, but still give access to services for our children? Why can't we do both at the same time?" She added that officials are "going in with a sledgehammer when really we should be going in with a scalpel."
The consequences are already being felt. According to the Georgia Recorder, one Georgia foster mother has been told that her nearly 3-year-old son's provider may be forced to stop treating him just as he began making progress. Foster children with autism depend on regular therapy to develop everyday skills, and a sudden loss of that support could set them back. "If they don't learn these school skills at an early intervention or an early age, it'll be a lot more costly later on," Sanders said. Kelsey Bennett, another family advocate with the Autism Families Alliance, said the situation reflects a broader failure to balance fraud enforcement with access to care. "Reforms that improve care, increase efficiency and prevent abuse are something we all support, but when those efforts make it harder for children with autism to get the care they need, something has gone terribly wrong," Bennett said. "No one wants to eliminate waste, fraud and abuse more than the providers who dedicate their lives to caring for these children. Every taxpayer dollar should go toward helping the people it was intended to serve. But you can't fix a system by making it harder for vulnerable children to get help."
Bennett urged Georgia lawmakers to bring together all stakeholders, including Medicaid managed care companies and frontline providers, to find a better path forward. "By listening to those on the front lines and working together, they can find a better way forward that improves efficiency without putting children's access to care at risk," she said. "Children with autism, especially those in foster care and those welcomed into loving foster families, already face enough challenges. Their families shouldn't have to worry about whether the care they depend on will suddenly disappear. Georgia's leaders need to step in, address these cuts and make sure these children aren't left behind." The Autism Families Alliance is calling on policymakers to ensure that fraudsters are removed from the system without creating unnecessary barriers for families of vulnerable children seeking care.