Ensure Your State Health Exchange Plans Include Services by Audiologist and SLPs

States are developing their exchange plans now; therefore, the window of opportunity to advocate for audiology and speech-language pathology services is limited, so act now.

(March 6, 2013)

ASHA has been working with members throughout the United States regarding an issue related to states attempting to define habilitation services. ASHA members worked diligently to ensure that habilitation and rehabilitation services were included as essential health benefits under the Affordable Care Act (ACA), but now we must continue to work at the state level to define habilitation as specifically including speech-language pathology and audiology as well as occupational and physical therapy. One particular trend of concern is habilitation being limited to applied behavior analysis (ABA) services only. This trend includes no mention of audiology, speech-language pathology, or occupational and physical therapy.


Currently, states are determining how to operate their exchange plans based on one of three options.

  1. State-based exchange: California, Colorado, Connecticut, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont, Washington, and the District of Columbia
  2. Partnership exchange: Arkansas, Delaware, Iowa, Illinois, Michigan, New Hampshire, and West Virginia
  3. Federal exchange: Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, Tennessee, Virginia, Wisconsin, and Wyoming

The links below provide information on the status of your state regarding exchange plans, the state entity responsible for designing the plan, agency members, and contact information.

ASHA Resources

Additional information on essential health benefits is available on ASHA's website. This includes a sample advocacy letter regarding habilitation and rehabilitation benefits [PDF] as well as the Technical Assistance for States to Design Essential Health Benefits Packages for Rehabilitative and Habilitative Services and Devices [PDF].

Need more assistance? We are working with ASHA members to assist with this trend. If you need assistance or more information, please e-mail or call one of the following ASHA staff members.

ASHA Corporate Partners