Adequate Health Insurance for Children with Autism

Evidence and Implications for Defining Essential Benefits – Families raising children with autism contribute significant amounts out-of-pocket to the cost of care and that this pay-as-you-go strategy is associated with disparities in use for vulnerable families (Thomas, Williams et al, 2013; Parish, Thomas, Williams et al, 2013). As a result, in comparison to other children with special health care needs, families of children with autism are more likely to report unmet need for care and financial difficulties (Thomas et al, 2012; Parish, Thomas et al, 2012a&b). There is evidence from national data that children with special health care needs who have both private insurance and Medicaid are less likely to experience barriers to care than those with private insurance alone, but there is a major research gap about the extent to which combined coverage provides adequate insurance for children with autism, how it improves access to care, and its impact on the mix and level of mental and other health care services they use. The long-term goal of this research is to improve access to care and outcomes for children with autism. The objective of the proposed study is to inform state deliberations about new definitions of essential benefits for mental health and other health care services by i) identifying the segment of children with autism who have the most adequate health insurance and ii) examining their health service use. We hypothesize that having combined coverage will be associated with greater insurance adequacy and increase the breadth and amount of service use particularly for mental health services.
Principal Investigator: Joseph Morrissey, PhD, and
Kathleen Thomas, PhD
Funding Source: Maternal & Child Health Bureau/HRSA
Project Period: 09/01/13 – 08/31/14