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MO Agency: Autism Treatment Grows, Costs Stay 'Negligible'

February 03, 2014

JEFFERSON CITY (February 3, 2014) -- Over 3,000 Missourians with autism are accessing treatment through the state's 2010 autism insurance reform law, but the impact on overall claims cost remains "negligible" at 0.2 percent, a state agency reported today.

The findings by the Missouri Department of Insurance, Financial Institutions & Professional Registration (DIFP), submitted annually to the Legislature, offer valuable insight nationally into the real-life costs of requiring coverage of autism benefits by law.

“Missouri's 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 continued low impact on overall health insurance claims."

In opposing the 2010 Missouri bill, the insurance industry claimed the requirement would boost premiums as much as 3 percent. But according to the new DIFP report, the claims impact for 2013 was 0.2 percent.

"Since claims are only one component of total costs that impact health insurance rates," DIFP concluded, "the overall impact of the mandate on rates is likely to be significantly less than 0.2 percent."

The 2013 report found that 3,070 Missourians with autism accessed coverage in 2013, up from 2,508 in 2012. While this represented a 22.4 percent increase, the resulting cost impact was 20.5 percent. Of the 3,070 participants, 2,165 were under age 18 and therefore eligible under the law for coverage of applied behavior analysis (ABA).

"Policymakers look closely at these cost impacts when weighing whether to require coverage for autism treatments by law," said Lorri Unumb, Esq, Autism Speaks executive vice president for state government affairs. "What too often gets lost are the benefits for people with autism who receive this treatment.

"The Missouri experience clearly demonstrates a 'win-win' scenario for costs and benefits," she said.

The Missouri law applies to state-regulated health plans and requires ABA coverage up to age 18. Fully funded large and small group plans are required to provide the coverage; individual plans are required only to offer the coverage.

However, under the Affordable Care Act, all new individual plans starting this year must cover autism benefits, including ABA. 

State-regulated health plans in Missouri cover 1.3 million state residents.