How Trump’s Health Picks Could Actually Help on Autism

UnitedHealthcare is cutting access to the gold-standard treatment for autism, targeting the poorest American families. Kennedy & gang should stop chasing baseless claims on vaccines and help fix this!

There’s been a lot written about the bad things Trump’s health teams may do when they get into office, including by me. They seem mostly concerned at this point about backing up baseless claims about vaccines, raw milk, psychedelics and the like.

But there are good things this group, led by Robert F. Kennedy Jr., could do, particularly in the realm of autism, a lifelong condition that can affect behavior, communication, interactions and learning. The number of kids with autism has risen from about 1 in 150 to 1 in 36 over two decades and Kennedy, Trump’s pick as Health and Human Services chief, has often expressed his concern for children with autism.

But while Kennedy and Dave Weldon — Trump’s pick to run the CDC — seem desperate to blame this growth on the overuse of vaccines, real-world experts in the field tag it to greater public awareness and improved screening. They also note that since 1994, when conditions identified as Asperger’s Syndrome and Heller Syndrome were included in a recognized "autism spectrum,” the diagnosis encompasses a wider band of severity from very mild to extreme.

However the rise in numbers came about, it only makes sense that this increase has raised costs for insurers. One result: ProPublica reported yesterday that UnitedHeathcare and Optum, the division that manages United’s mental health benefits, is putting in place what PropPublica terms a “secret internal cost-cutting campaign'“ that limits access to Applied Behavior Analysis, or ABA, the evidence-based gold standard treatment,

In particular, according to ProPublica’s report, it seems they’re targeting the nation’s poorest and most vulnerable patients, children in families covered through the company’s state-contracted Medicaid plans in about two dozen states.

Kennedy has long attacked vaccines, saying on a 2023 podcast that there is “no vaccine that is safe and effective,” and urging people to resist CDC’ guidelines about if and when kids should get vaccinated. The New York Times reported the other day that Aaron Siri, the lawyer who’s been Kennedy’s right-hand man in selecting who he’ll hire if he gets to lead America’s health team, filed suit against the FDA two years ago to stop use of the polio vaccine.

How bizarre is that?

Kennedy has said he won’t take vaccines away from people, but that he no longer wants them to be supported by the federal guidelines backed by research that help doctors — who can’t do the level of study needed to determine these things — follow the best course of action.

The problem here: If the polio virus circulates in populations with low vaccination levels, people can again get the disease and it can mutate to a form that might not be covered by the existing vaccine. All viruses have the ability to mutate and change to some degree, as we’ve seen with Covid and the flu, though the rate of mutation can vary.

Rather than trying to prove the unprovable about some kind of link between autism and vaccines shown to be safe over decades in millions of children, perhaps Trump’s new health-care team can make sure kids with autism get proper treatment for as long as they need it, no matter how poor their families might be.

“Key opportunities” for cutbacks are outlined in internal documents for Optum reviewed by ProPublica. While acknowledging some areas have “very long waitlists” for the therapy, the company says in these documents that it will seek to “prevent new providers from joining the network” and “terminate” existing ones, including “cost outliers.” In some states, this could impact almost 20%s of autism patients.

The Optum plan particularly targets the children of families on Medicaid, the nation’s poorest and most vulnerable patients, in about two dozen states, ProPublica reported. It comes as Optum, in its internal reports, admits that the therapy, called applied behavior analysis, or ABA, is the “evidence-based gold standard treatment for those with medically necessary needs.”

Nonetheless, the company is “pursuing market-specific action” to limit their payouts, according to ProPublica. The move comes despite the fact that ABA has been designated as a protected benefit under the federal mental health parity law. At the same time, legislators have passed laws in every state requiring insurance companies to pay for it.

United and Optum declined requests from ProPublica to answer questions about their coverage, citing the murder of UnitedHealthcare CEO, Brian Thompson, in Manhattan on Dec. 4. It was an attack, you might recall, that stirred up a startling bitter online stew against him and other health insurers, with hundreds writing that these companies too often deny medical coverage and payments.

Meanwhile, ValuePenguin, a website that researches financial products and services, has reported that UnitedHealthcare denies more than 30% of all medical claims, twice the industry average. And now the autism denials are incoming, one more way to save a dollar for a company that made $16.4 billion in profit in 2023.

Think about this, folks, when the MAGA Congress votes on whether to hand Medicare entirely over to private companies under Trump, something they’re already talking about.

Here, in this instance, we have the potential for hundreds, or maybe thousands, of poor kids unable to be treated for a condition that is treatable by a company that made a profit of almost $20 billion last year and paid its top executive total compensation of $10.2 million. And this is just one disorder; consider how many others may be similarly affected.

Kennedy has a few good ideas; let’s give him that. For instance, he’s called for the removal of thousands of additives from U.S. foods, rooting out conflicts of interest at agencies and incentivizing healthier foods in school lunches and other nutrition programs. He’ll certainly highlight this part of his agenda and likely seek to downplay his attacks on vaccines when he meets with the U.S. Senators seeking their approvals in the next week or so.

But the big picture here is disturbing.

Kennedy could do more, much more within the real world to help kids on the “autism spectrum” than simply attack vaccines, like the one that keeps us all from, getting polio. What do you think?