Autism Spectrum Disorders and Families' Financial Burden: The Association With Health Insurance Coverage
Methods: We used pooled data from the 2000-2009 panels of the US-based Medical Expenditure Panel Survey to examine out-of-pocket spending incurred by families caring for children with autism (n=316). The survey is nationally-representative of US families. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families’ income. Logistic and OLS regression models estimated families’ likelihood of having any out-of-pocket spending for the health care of their child with autism and relative financial burden among families that incurred any out-of-pocket spending, respectively.
Results: 82% of US families incurred any out-of-pocket spending for the health care costs of their child with autism in the past year. Families spent an average of 4.1% of income per capita on their child’s health care. After controlling covariates including severity of the condition and other family and child characteristics, families raising children with private health insurance were more than five times as likely to have any out-of-pocket spending compared to children with public health insurance. The most common expenditure types were medications, outpatient services, and dental care.
Conclusions & Implications: Families of privately-insured children with autism spectrum disorders incur significantly greater out-of-pocket spending for their children’s health care. This study provides additional evidence of the relative inadequacy of private health insurance coverage in meeting the needs of US children with autism spectrum disorders. Improving private insurance coverage, particularly in medications, outpatient services and dental care, would reach a large proportion of families raising children with autism and reduce their financial burden.