Brief report: Quantifying the impact of autism coverage on private insurance premiums.

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TitleBrief report: Quantifying the impact of autism coverage on private insurance premiums.
Publication TypeJournal Article
Year of Publication2009
AuthorsBouder, JN, Spielman, S, Mandell, DS
JournalJ Autism Dev Disord
Date Published2009 Jun
KeywordsAdolescent, Autistic Disorder, Child, Child, Preschool, Health Expenditures, Hospital Administration, Humans, Insurance Coverage, Pennsylvania, Young Adult

Many states are considering legislation requiring private insurance companies to pay for autism-related services. Arguments against mandates include that they will result in higher premiums. Using Pennsylvania legislation as an example, which proposed covering services up to $36,000 per year for individuals less than 21 years of age, this paper estimates potential premium increases. The estimate relies on autism treated prevalence, the number of individuals insured by affected plans, mean annual autism expenditures, administrative costs, medical loss ratio, and total insurer revenue. Current treated prevalence and expenditures suggests that premium increases would approximate 1%, with a lower bound of 0.19% and an upper bound of 2.31%. Policy makers can use these results to assess the cost-effectiveness of similar legislation.

Alternate JournalJ Autism Dev Disord
PubMed ID19214727
PubMed Central IDPMC2862974
Grant ListR01 MH077000 / MH / NIMH NIH HHS / United States
R01 MH077000-04 / MH / NIMH NIH HHS / United States
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