State mandates for autism treatment coverage don't go far enough

New research indicates that state mandates for insurance coverage of autism treatment are "necessary but not sufficient" for helping individuals access needed therapies, according to Kaiser Health News.

The findings--presented Wednesday at a conference on autism spectrum disorder and due to be published this summer--show that current state mandates led to an average of 12 percent more children receiving some kind of autism treatment from 2008 to 2012. However, that figure doesn't come close to the number of children on the autism spectrum, which the Centers for Disease Control and Prevention estimates as 1 in 45 based on 2014 data.

This "suggests that a lot of commercially insured kids with autism are not being treated through their insurance," David Mandell, one of the researchers and the director of the University of Pennsylvania's Center for Mental Health Policy and Services Research, said at the conference.


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If autistic children aren't treated early, the condition will become more complicated--and more costly--to treat in the long run, the KHN article says. But even when coverage mandates are in place, it is often not clear what insurance companies are actually required to cover, and parents of autistic children may not be fully informed of their coverage options.

Insurance companies, however, point out that the current regulations have resulted in about a 1 percent premium increase so far, and say that could grow if plans are forced to cover more services or autism rates keep climbing. Already, some insurers have had to pay penalties related to the mandates: Last year, the state of Missouri fined Aetna $4.5 million for violating its autism treatment and abortion coverage laws.

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