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Missouri Finds 'Negligible' Cost Impact for Autism Insurance Benefits

February 05, 2013

JEFFERSON CITY (February 5, 2013) -- A Missouri state agency has found that the state's 2010 autism insurance reform law fully ramped up in 2012, yet still produced "negligible" impact on the state's overall health costs. The $6.6 million for autism benefits represented 0.16 percent of total health claims, a fraction of the 3 percent impact insurance lobbyists had warned when fighting the bill in the legislature.

The findings were contained in the second annual report on the 2010 insurance law submitted by the Missouri Department of Insurance, Financial Institutions & Professional Registration (DIFP) to the Legislature as required under the law.

"Missouri's new landmark autism insurance law continues to deliver benefits for families impacted by autism," said John M. Huff, director of the Missouri Department of Insurance. "Especially encouraging is the extremely low impact on overall health insurance claims."

The first annual report reflected the fact that 2011 was "a transitional year during which much of the infrastructure necessary to deliver the mandated benefits was developed," DIFP reported. "As expected, data show that the benefits of the mandate were more fully realized in 2012, while the costs as a percent of overall health care costs remained negligible."

The report went on to note that, "Since claims are only one component of total costs that impact health insurance rates, the overall impact of the mandate on rates is likely to be significantly less than 0.16 percent."
 
Between 2011 and 2012, claims costs associated for autism benefits increased from $4.3 million to $6.6 million of which less than half ($3 million) was for coverage of applied behavior analysis (ABA). The fiscal impact amounted to 38 cents per member per month, less than the cost of a postage stamp.
 
Meanwhile, the number of licensed ABA practitioners grew 44 percent between 2011 and 2012 and totaled 167 as of January 2012.
 
"This new study further validates our own experiences across the states which have enacted autism insurance reform," said Lorri Unumb, Esq., Autism Speaks' vice president for state government affairs. "Expanding access to proven medical treatments through insurance reform creates a better quality of life for our children, while saving taxpayers millions of dollars in avoidable future costs for special education and social services."
 
The Missouri law applies to state-regulated health plans and requires ABA coverage up to age 18. The original $40,000 cap on ABA benenfits has been adjusted upwards to $42,117 for 2013.