People need habilitation when they have a congenital defect or disease that impairs the development of basic life skills. For example, autism may leave a child unable to speak. Cerebral palsy may result in language delays and severe physical limitations. Birth defects may leave a child deaf.

Thanks to the Affordable Care Act, or ACA, habilitation services will now be widely covered for the first time in private insurance plans. Rehabilitative and habilitative services are among the 10 "essential benefits" that must be provided by all plans sold on all the state and federally run health insurance exchanges. Starting in 2014, all individual and small group health policies sold outside the exchanges also will have to cover habilitative services.

But as is the case with some of the other "essential benefits," the federal health law mandates coverage of habilitation services without spelling out exactly what that means. The states, together with insurers and advocacy groups, will have a big say in what, and how much, is covered.

Proposed coverage requirements by Washington health insurers include speech therapy, occupational therapy, and aural (hearing) therapy, but not services provided at school pursuant to an Individual Educational Program (IEP). Parents may want to write the Washington State Insurance Commission with comments before the rules are finalized.