A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health has found that the enactment of state laws mandating coverage of autism spectrum disorder, or ASD, was followed by sizable increases in insurer-covered ASD care and associated spending.
Over the past decade, 46 states have passed laws requiring coverage of autism by private health insurers. The study found that children in states that required ASD coverage were more likely to receive treatment.
"The hope of patient advocates and policymakers was that these insurer mandates would increase care for children with autism, and they seem to have done that—in fact, the impact was even larger than we had expected," says Colleen L. Barry, professor and chair of the Department of Health Policy and Management at the Bloomberg School.
The results, Barry adds, are important for states that have enacted such mandates to understand their impact, and also helpful for states considering whether to broaden mandates that are already in place. Barry is also affiliated faculty with the Johns Hopkins Wendy Klag Center for Autism and Developmental Disabilities at the Bloomberg School.
ASDs are brain development disorders that feature language and communication deficits, highly restricted interests, and repetitive behaviors. Currently about 1.5 percent of children born in the United States every year are diagnosed with an ASD, typically in early childhood. There is no known treatment that prevents or reverses ASD, but early diagnosis and intervention are considered critical in mitigating ASD symptoms.
The study, published in the October issue of Health Affairs, was a collaboration with researchers at the University of Pennsylvania. The research team examined data from three nationwide private health insurers—United Healthcare, Aetna, and Humana—from 2008 through 2012, the period in which most states enacted their mandates for ASD coverage.
ASD coverage by private insurers is still an ongoing policy issue in many states, even those that mandate coverage. Some state mandates only require ASD coverage for children in narrow age ranges, even though treatment through childhood and into adulthood can be effective, and place caps on annual coverage amounts.
"We think the findings from this study can influence the debate in states that are thinking about expanding the scope of their laws by covering more children," Barry says, "especially those considering expanding their age eligibility to cover older children and those transitioning into adulthood."