State autism mandates falling short, study finds

New research evaluating state laws that require health insurers to cover autism treatments suggests these efforts are failing in key ways to help people — especially children — get needed therapy (Source: “Questions Emerge About The Impact Of State Autism Insurance Mandates,” Kaiser Health News, May 11, 2016).

Forty-four states (including Ohio) and the District of Columbia have so-called “insurance mandates” that require coverage of autism treatment. Researchers found that the state mandates — which apply to coverage available on the individual market and some group and employer plans — led to about 12 percent more children getting some kind of treatment for autism. But when compared with the number believed to have the condition, it’s not nearly enough, they say.

“These numbers are orders of magnitude below” the CDC’s autism estimates, said David Mandell, one of the researchers and the director of the University of Pennsylvania’s Center for Mental Health Policy and Services Research. “It suggests that a lot of commercially insured kids with autism are not being treated through their insurance.”

The shortfall may have significant health consequences, said Daniele Fallin, who chairs the Johns Hopkins University department of mental health and directs Hopkins’ Wendy Klag Center for Autism and Developmental Disabilities. For children, it’s important to get treatment as soon as possible. If that doesn’t happen, the condition will become more complicated — and more costly — to treat in the long run.

The findings, which were to be presented last week at a major conference on autism spectrum disorder, will appear this summer in JAMA Pediatrics.