State mandates requiring commercial health plans to cover the cost of services for children with autism have resulted in more children being diagnosed and treated for the disorder, according to research published this week in the journal JAMA Pediatrics. Until recently, most health insurance plans did not cover the high costs associated with such care.
In addition, the researchers noted that the number of children diagnosed and receiving therapy for autism increased the longer a state mandate was in effect – from a 10 percent increase the first year to more than 18 percent after three years. However, the number of children diagnosed and receiving care remained far below the estimated prevalence of autism in the United States, the study found, suggesting that many families lack access to affordable autism services for their children.
Autism Speaks issued a statement in response to these findings:
This study reinforces Autism Speaks’ long-standing position that autism insurance mandates are a critical tool to ensure every individual receives the evidence-based health care for autism they deserve. Autism Speaks is pleased the laws the community has worked so hard to get passed have increased the detection and treatment of autism. We have committed significant resources to enact, implement and enforce policies that ensure every autism family has access to the health care they need.
As noted by the study’s authors, barriers that impede access to care continue to exist, and regulatory issues remain. As we work with autism families around the country, we regularly see situations in which willing providers are unable to join networks; the credentialing process takes half-a-year to complete; reimbursement rates are set at unreasonably low levels; and discriminatory restrictions spring up regarding time and location of services, parental involvement, and more. We will continue our work with families and regulators to address these issues.
For more on this research, also see:
Study suggests insurance mandates help close gaps in autism care
Read about Dr. Mandell’s Autism Speaks-funded research
on the economics of autism here.