NASEM Recommends Expanding TRICARE Coverage for ABA Services 

The National Academies of Sciences, Engineering, and Medicine (NASEM) have released an important new report on the Comprehensive Autism Care Demonstration (ACD) program. This program has provided Applied Behavior Analysis (ABA) therapy to children with autism in military families since 2014. After years of study, the report calls for significant changes that could make access to ABA easier, more consistent, and less stressful for families. 

The committee’s most important recommendation is that the Defense Health Agency (DHA) should end the ACD and make ABA a basic TRICARE benefit. This would mean ABA is recognized as a medically necessary service, just like speech, occupational, or physical therapy, and would be covered under standard TRICARE benefits rather than through a special demonstration program. 

The report also urges DHA to stop requiring unnecessary assessments such as the PDDBI, Vineland-3, and SRS, which have added time and stress for families and providers. It recommends reducing administrative barriers that make it harder to start or continue services and allowing ABA providers more flexibility to meet each child’s individual needs. NASEM also encourages TRICARE to permit ABA services in all appropriate settings, including schools and community environments, where children can best learn and generalize their skills. 

These changes would bring TRICARE policies in line with what is already standard practice across most states and insurance plans. 

At Butterfly Effects, we strongly support these recommendations. Every child deserves access to high-quality ABA services, and every parent deserves a process that supports rather than complicates their child’s care. This report represents an important step forward in recognizing ABA as an essential, evidence-based service for military-connected families. 

Read the full report here.