Children and youth with autism spectrum disorder and other developmental disabilities (ASD/DD) are a subpopulation of children and youth with special health care needs (CYSHCN). As with all CYSHCN, they require a comprehensive array of medical, behavioral and developmental health services. Children with ASD/DD often have inadequate insurance coverage, putting them at risk for missed or delayed care and leaving their families with significant financial burdens. The 2010 Patient Protection and Affordable Care Act (ACA) is designed to increase health coverage, improve the level of benefits, and provide important new insurance protections for all Americans. Many of the law's provisions impact children, including those with ASD/DD. This issue brief describes selected provisions in the ACA that have implications for CYSHCN with ASD/DD. It also describes how state Title V MCH programs can maximize opportunities under the ACA to develop and strengthen systems of care for CYSHCN with ASD/DD.