ProPublica Drops Damning Expose on Leaked UnitedHealthcare Report About Limiting Child Healthcare Services To Cut Costs

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A leaked report reveals UnitedHealth Group, the nation’s largest insurer, systematically limiting access to critical autism therapy by culling providers and leaving families and advocates outraged.

The damning internal documents obtained by ProPublica reveal that the company has implemented cost-cutting measures targeting applied behavior analysis (ABA), a widely recognized therapy for children with autism.

UnitedHealth’s report acknowledges ABA as the “evidence-based gold standard treatment” but outlines strategies to reduce its availability. These include removing providers from their network and denying therapy hours requested by clinicians. The strategy primarily targets those children who are the poorest and most vulnerable, covered through the company’s state-contracted Medicaid plans.

One bullet point in the documents suggests terminating “cost outliers,” even in regions with long waitlists. The strategy has already impacted up to 19 percent of patients receiving ABA therapy in some states, ProPublica found.

UnitedHealthcare and Optum declined ProPublica’s request for an on-the-record interview about their behavioral health care coverage, a request made over a month ago.

Questions emailed 11 days ago remain unanswered, with the company citing the December 4 killing of UnitedHealthcare’s CEO Brian Thompson as the reason.

In an emailed statement, a spokesperson replied: “We are in mourning” and said they could not engage with a “non-urgent story during this incredibly difficult moment in time.” Despite being offered extra time to respond, the companies did not agree to a deadline for comment.

ProPublica presented the case of Sharelle Menard, a single mother from Louisiana who has been fighting to secure sufficient ABA therapy for her son, Benji, who is severely affected by autism. Once unable to speak, Benji made remarkable progress with intensive therapy, but UnitedHealth recently began denying the full 33 weekly hours his clinicians deem necessary.

Menard is now terrified of losing the gains her son has made. “They’re cutting and denying an unethical amount,” said Whitney Newton, Benji’s behavior analyst.

Speaking with the publication, Karen Fessel, an advocate for autism care, labeled the company’s tactics as “unconscionable and immoral.”

She criticized UnitedHealth for shrinking its network while knowing there was an urgent need for services. Experts echoed her concerns, with Tim Clement of Mental Health America describing the moves as “a blunt instrument to chase after excessive costs.”

Deborah Steinberg, an attorney with the Legal Action Center, noted to ProPublica that insurers like UnitedHealth must comply with the federal mental health parity law, which mandates equal access to mental and physical care.

As Menard braces for an appeal hearing next month, she hopes for a reversal of the insurer’s denial.

“They’re denying kids access to medically necessary care,” said president of the Autism Legal Resource Centre and attorney Dan Unumb, “and that’s a terrible solution.”