Autism spectrum disorders and families' financial burden: The association with health insurance coverage

Objectives. We examined the relationship between family financial burden and children's health insurance coverage in families raising children with ASD. Methods. We used pooled data from the 2000-09 MEPS to examine out-of-pocket spending incurred by families caring for children with ASD (n=316). Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families' income per capita. Logistic and OLS regression models estimated families' likelihood of having any out-of-pocket spending for the health care of their child with autism spectrum disorders and relative financial burden among families that incurred any out-of-pocket spending, respectively. Results. About 82% of families incurred any out-of-pocket spending for the health care costs of their child with autism spectrum disorders in the past year. Families spent an average of 4.1% of income per capita on their child's health care costs. Net of covariates, families raising children with private insurance were more than five times as likely to have any out-of-pocket spending compared to children with public insurance. Among families with any out-of-pocket spending, the most common expenditure types were medications, outpatient services, and dental care. Conclusions. The study indicates that families of privately-insured children with ASD incur significantly higher out-of-pocket spending for their children's health care, which is additional evidence of the relative inadequacy of private insurance in meeting the needs of children with ASD. Improving private insurance coverage, particularly in medications, outpatient services and dental care would reach a large proportion of families raising children with ASD.