Transition-Age Medicaid Coverage for Adolescents With Autism and Adolescents With Intellectual Disability.
Lindsay L Shea, Robert Field, Ming Xie and 3 others
PMID 30835524WHAT IT FOUND
Adolescents with autism were 11% more likely to lose Medicaid coverage than those with intellectual disability, but this difference vanished when accounting for enrollment category.
Most who lost coverage did not regain it within five years.
Key findings
01In the fully adjusted model, adolescents with ASD were 11% more likely to disenroll from Medicaid than adolescents with ID.
02When Medicaid enrollment category was included as a covariate, the greater risk of disenrollment in the ASD group was no longer statistically significant.
03More than 60% of young adults who had disenrolled had not re-enrolled in Medicaid 5 years after initial disenrollment.
STILL TO COME
How it was doneWhat they found
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What it does not show
The data only covers Medicaid claims and provides no information on whether adolescents obtained private health insurance or other supports after disenrolling. The study period is 2001-2005, which predates the Affordable Care Act's Medicaid expansion, so current coverage patterns may differ. Diagnoses were based on claims data, which may result in misclassification of ASD or ID. Disenrollment was defined as a three-month gap in coverage, which may not always represent a true loss of eligibility. The study did not track adolescents who disenrolled to determine if they gained coverage elsewhere or regained Medicaid after five years.
The easy way to misread this
Do not conclude that autism itself causes higher Medicaid disenrollment. The study found that the difference between autism and intellectual disability groups disappeared when accounting for how the adolescents qualified for Medicaid, suggesting that enrollment category (such as poverty versus disability) is the stronger predictor of losing coverage.