Missouri Reports Autism Claims Cost $6 Per Member Per Year Following Autism Mandate

In the three years since 2011 when Missouri implemented an autism insurance mandate, commercial health insurance claims costs reached $.50 per member per month (PMPM) ($6.00 per year), with $0.26 PMPM for applied behavior analysis (ABA). The mandate requires health plans regulated by the state to cover the cost of ABA for covered members under age 18.

In the state, the cost of autism-related diagnosis and treatment in the commercially insured population increased by 127.5%, from $4.3 million in 2011 to $9.8 million in 2014. Since 2011, claims costs for ABA specifically increased by . . .