THE REALITY OF THE RIGHTS OF CHILDREN WITH AUTISM SPECTRUM DISORDER IN THE NORTHERN REGION: THE UNILATERAL CANCELLATION OF HEALTH PLANS AND THEIR COMPLIANCE WITH CURRENT LEGISLATION

Abstract

This study analyzes the compliance of the unilateral cancellation of health insurance plans for children with Autism Spectrum Disorder (ASD) with current legislation, in light of the growing judicialization of this practice. Although Brazilian legislation—through the Federal Constitution of 1988, Law No. 12.764/2012 (Berenice Piana Law), Law No. 13.977/2020 (Romeo Mion Law), and the Statute of the Person with Disabilities (Law No. 13.146/2015)—ensures the continuity of treatment for children with ASD, health insurance providers often adopt restrictive measures that limit or interrupt this care, resulting in litigation to defend this fundamental right. The legal debate also involves divergent interpretations regarding the mandatory nature of coverage, considering the distinction between the exhaustive and illustrative lists of the National Supplementary Health Agency (ANS), which directly impacts access to treatment. Using a quantitative-qualitative and documentary approach, the research analyzes court decisions extracted from legal databases to identify the main arguments used to contest the cancellation of health insurance plans. The results show that the lack of clear regulation and the restrictive interpretation by health insurers compromise the right to continuous care, prompting families to seek judicial support to guarantee access to necessary treatments. Thus, the study highlights the need for increased oversight and regulation of health insurance providers in order to ensure compliance with current legislation and prevent violations of the rights of children with ASD, thereby guaranteeing the effectiveness of the right to health.