Massachusetts Expands ABA Therapy Coverage to Children with Down Syndrome
In January 2025, Massachusetts Governor Maura Healey signed a groundbreaking bill into law—An Act regarding Applied Behavioral Analysis for Down syndrome. This new legislation requires both private insurers and MassHealth to cover in-home ABA therapy for children who are diagnosed solely with Down syndrome, a major expansion of services that had previously been limited primarily to those with Autism Spectrum Disorder (ASD).
Why This Matters
Prior to this law, families of children with Down syndrome often struggled to access ABA therapy unless their child also had an autism diagnosis. This created significant gaps in care for children who could benefit from behavioral interventions but were excluded due to outdated coverage policies. The new law directly addresses this issue by ensuring that children with Down syndrome are no longer left behind when it comes to accessing effective, in-home behavioral support.
What the Law Covers
The legislation mandates insurance coverage for in-home ABA therapy, as well as occupational, physical, and speech therapies, for children with a sole diagnosis of Down syndrome. This is a first in the state’s history, expanding access to interventions proven to help with communication, adaptive functioning, and behavioral development.
Importantly, the bill sets the implementation date for January 1, 2026. This gives providers, insurers, and families time to prepare for the transition and ensure services will be available when the law goes into effect.
The Role of ABA Therapy for Down Syndrome
ABA therapy, often associated with autism, is a structured, evidence-based treatment focused on reinforcing positive behaviors and building essential life skills. For children with Down syndrome, ABA has shown promise in improving social interaction, communication, and behavior regulation—key areas that can impact long-term independence and quality of life.
A Win for Advocacy
The Massachusetts Down Syndrome Congress (MDSC) was a leading advocate behind the bill, working for six years to push this legislation forward. Executive Director Maureen Gallagher emphasized how transformative this coverage could be for families, calling the bill a “game-changer” for those previously denied access due to insurance limitations.
Lawmakers across the aisle supported the bill, including State Representative Jack Patrick Lewis and Senator Joan B. Lovely. Senate President Karen Spilka and House Speaker Ron Mariano also played key roles in advancing the legislation.
What Comes Next
Families with children who have Down syndrome should begin conversations with their pediatricians and specialists to understand how this new coverage may apply. Providers, too, will need to prepare to serve an expanded group of clients as the law rolls out in 2026.
This legislation marks a significant step forward in equitable access to care. It recognizes that children with Down syndrome deserve the same support and opportunities for growth that have long been available to children with ASD. As Massachusetts becomes the first state to enact such a law, it sets a precedent for others to follow.
