Mandating Autism Coverage Could Increase Insurance Rates
Mandating health insurance companies to provide coverage for IBIS-- intensive behavioral intervention services--for South Dakota children with autism could increase costs 50 cents to $2.50 per insured person per month.
Health Management Associates released its study this week to the state of South Dakota on requiring the IBIS mandate and other issues surrounding the treatment of children with autism. The 2014 South Dakota Legislature requested the study.
“We estimate that starting in 2016 and in the short-term, the additional premium cost for covering IBIS for children through 18 years of age is approximately $0.50 per insured member per month,” the report’s executive summary noted.
However, the study added that the 50-cent number “reflects a provider network that is currently not adequate to serve the potentially eligible population of children.”
Expanding that network could mean still higher insurance costs, according to the study.
“The ultimate premium impact may be as much as $2.50 per member per moth using the high-level assumptions outlined in the report,” the executive summary said.
The report estimates additional costs of nearly 3 million dollars if the state mandates IBIS coverage—and possibly more.
“Further costs would be incurred to the State if the State were to expand the Employee Health Plan and Medicaid coverage to include IIBIS for children with ASD (autism spectrum disorders),” the report said.
MHA concluded that current South Dakota and federal law does not require IBIS coverage.
Currently, according to the report, the state spends $18.5 million annually for children with ASD through the state department of education, the Medicaid state plan, the CHOICES Medicaid waiver, the family support Medicaid waiver, the state health insurance plan and a grant to the University of South Dakota Center for Disabilities.