The Journal of Autism and Developmental Disorders has a new article by Li Wang,
David S. Mandell, and colleagues: "Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison Between
Medicaid and Private Insurance." From the concluding discussion:
This study is the first to directly compare healthcare utilization and costs for children with ASD enrolled in Medicaid versus private insurance using nationwide claims data. We found that average healthcare expenditures for Medicaid-enrolled children with ASD were four times higher than those of children enrolled in private insurance plans. ASD-specific healthcare costs alone in Medicaid were higher than the total healthcare costs in private insurance per child with ASD. Medicaid-enrolled children with ASD received many more services than those enrolled in private insurance. Every state in our study sample had greater expenditures per child with ASD in Medicaid than in private insurance.
The study identifies some possible reasons for the difference:
- Children in Medicaid may be sicker and therefore need more care.
- Medicaid eligibility criteria are quite different, which may result in a more severely ill population.
- Children in Medicaid got more autism-specific services such as speech, OT, and behavior modification.
- Medicaid covers different services, some of which (e.g., long-term care) are costly.
