Jefferson City -Gov. Jay Nixon announced in a media release that the annual Autism Report from the Missouri Department of Insuranceshows that more Missouri children are benefiting from the landmark law that requires insurance companies to cover treatment for autism-related conditions. The number of individuals treated for autism-related conditions increased by over 20 percent for the second consecutive year.
“Five years ago folks came together to expand health care access for Missouri children with autism, and today, that legislation continues to change lives,” Gov. Nixon said. “This latest report demonstrates what can be accomplished when leaders come together to improve the lives of Missourians through common-sense health care reform.”
The number of individuals receiving covered treatment in 2014 was 3,825 – up from 3,070 in 2013 and 2,508 in 2012. Even as the number of Missourians receiving covered treatments rises, claims for autism-related treatments make up only a small fraction of the more than $4.7 billion in claims paid by Missouri health insurers during 2014.
“The landmark legislation signed by Gov. Nixon in 2010 continues to make a real and lasting difference for thousands of Missouri families,” said John M. Huff, Director of the Missouri Department of Insurance. “Nearly all Missourians in the fully insured market now have access to coverage for autism treatments. These claims make up only a small fraction of the total claims paid by health insurers, but they make a huge difference for the families who benefit.”
The 2010 law, signed by Gov. Jay Nixon, requires health insurance companies to cover specific autism therapies, including applied behavior analysis (ABA). Payments for autism treatment increased 127 percent from 2011 to 2014. The number of individuals treated increased by a little over 50 percent from 2012-2014.
Using data supplied by insurance companies, the report says claims for autism-related treatments totaled nearly $10 million in 2014 – just a small fraction of the more than $4.7 billion in claims paid by Missouri health insurers during 2014.
The number of licensed professionals providing ABA treatment also continues to grow, with more than 288 providers currently licensed in Missouri. In 2014, the average policyholder seeking ABA treatment received $1,848 in autism services, just 4.6 percent of the annual maximum benefit of $43,427.
Other findings from the department’s report:
Across all market segments, the average per member, per month cost in 2014 for all autism-related claims was 50 cents and was just 26 cents for ABA treatments.
Nearly 1.3 million individuals received coverage from a licensed insurer. Adding public employees and other self-insured entities, the department estimates that as many as 1.6 million individuals have benefited from the autism mandate.
In 2014, treatment for autism became a required benefit for most large-group, small-group and individual plans. More than 92 percent of insureds in the individual market received coverage for autism treatments. That is up from last year when about one-third of consumers enrolled in the individual market had autism coverage. Previously, it was required in small- and large-group markets, but was optional coverage for individual policyholders.