The reversal arrived this week, and it matters because of who is doing the reversing. The Autism Families Alliance, a national group that publicly backed the Trump administration’s Medicaid fraud crackdown in August, is now warning that the crackdown has gone too far. Its target: a 30% cut to what Georgia pays for autism therapy for children in foster care.
Here is what happened. Amerigroup, the company that holds the sole Medicaid contract covering Georgia’s roughly 27,000 foster-care and adoption-assistance children, announced by letter in August that it would cut reimbursement for applied behavior analysis therapy by 30%, effective September 1. No vote. No hearing. A letter. And because Amerigroup is the only insurer these children can use, the families and foster parents absorbing the cut cannot shop for a better plan. There is no better plan.
Applied behavior analysis, or ABA, is the therapy at issue. For children with autism, it is often the difference between learning basic safety skills and not learning them. Taylor Sanders, a family advocate with the Alliance, told Fox News Digital that 75% of clinics will have to close or stop serving foster kids at the new rate, and she put the problem in a sentence the state should have to answer: the fraud effort is “a sledgehammer when really we should be going in with a scalpel.” That 75% figure is her warning, not a confirmed count of closures, but the direction of travel is not in dispute. Clinics were already dropping foster-care patients when the Georgia Recorder reported the cut on October 5.
The human cost is not abstract. Krystina McQueen, a foster mother in Hall County, told the Recorder her nearly three-year-old foster son had just begun making progress in his first weeks of therapy. Now she may lose his provider. Dr. Michelle Zeanah, who runs what the Recorder describes as the sole local option in her part of southeast Georgia, said that at the new rate her clinic would be “too far in the red” to keep going.
Amerigroup’s stated reason is alignment. The company said the cut was “intended to better align reimbursement across autism services,” and it raised what it pays for parent training instead. The advocates’ answer is that parents cannot substitute for trained clinicians, especially for children with severe behaviors who need to learn, among other things, how not to get hurt.
Georgia’s Department of Community Health says Amerigroup must secure out-of-network care on a case-by-case basis when no in-network provider is available. That is a real protection on paper. Whether families in crisis know to ask for it, and whether a case-by-case process can hold up a therapy schedule for thousands of children, are open questions. No Georgia legislator was on the record responding to the Alliance’s reversal as of this week.
Step back and the shape of the thing is familiar. A federal anti-fraud campaign, launched with cheers from the provider community, lands on the one population with the least power to push back: children in state custody, locked into a single insurer, whose therapy was cut by administrative letter. The fraud crackdown may or may not have been justified. What is not justified is the distribution of its costs, which fall on foster children with autism who did not commit any fraud and cannot leave the plan that is cutting them.
Kelsey Bennett, another advocate with the Alliance, urged Georgia lawmakers to bring the Medicaid managed-care companies and frontline providers “to the table.” That is the minimum. A 30% cut to therapy for children the state has taken responsibility for deserves more than a letter. It deserves a hearing, a vote, and an accounting of what happens to the kids on the other side of it.
