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HD 1016

An Act relative to insurance coverage for individuals with autism

194th Legislature (2025-2026) Introduced by Alan Silvia

Massachusetts bill mandates insurance coverage for autism spectrum disorder treatments including behavioral therapy and related services without annual limits.

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Bill Summary · HD 1016

Legislative bill overview

HD 1016 would require health insurance plans in Massachusetts to cover evidence-based treatments and behavioral health services for individuals diagnosed with autism spectrum disorder (ASD). The bill mandates coverage for applied behavior analysis (ABA) therapy, speech therapy, occupational therapy, and related diagnostic and evaluative services without annual or lifetime limits.

Why is this important

Autism treatment services are expensive and often inaccessible without insurance coverage, placing significant financial burden on families. Many insurance plans currently exclude or severely limit ASD-related treatments, forcing families to choose between treatment and financial stability. Mandated coverage would improve access to early intervention services, which research shows can significantly improve outcomes for individuals with autism.

Potential points of contention

  • Cost implications: Insurance companies argue mandated coverage increases premiums for all policyholders; supporters counter that early intervention reduces long-term costs
  • Scope of covered services: Disagreement over which treatments qualify as "evidence-based"—some therapies have limited scientific validation while others lack consensus on effectiveness
  • Age limitations: Unclear whether coverage extends to adults with autism or focuses primarily on children, affecting equity across age groups
  • Insurance market effects: Potential for insurers to exit the Massachusetts market or exclude autism diagnoses, similar to patterns seen in other states with ASD mandates

Compiled from official sources — confirm details with the bill’s official record.

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