Autistic individuals often rely on Medicaid for insurance, but the transition to adulthood can, and often does, impact their enrollment status. In continuing to examine how autistic individuals use Medicaid, recent research from Drexel University's A.J. Drexel Autism Institute has identified a trend in intellectual disability diagnoses among autistic young people that is likely indicative of a system-wide problem that makes it difficult for them to maintain coverage into adulthood.

In continuing to examine how autistic individuals use Medicaid, recent research from Drexel University’s A.J. Drexel Autism Institute has identified a trend in intellectual disability diagnoses among autistic young people that is likely indicative of a system-wide problem that makes it difficult for them to maintain coverage into adulthood. To examine this more closely, the Drexel team decided to look at whether autistic young people who experienced disenrollment from Medicaid were actually more likely than autistic young people who had not experienced disenrollment to be diagnosed with intellectual disability in adulthood. Led by Meghan Carey, a doctoral student in the Epidemiology and Biostatistics department in the Dornsife School of Public Health, the research team examined national Medicaid claims data from the 2008-2016 to study the probability of autistic young people, who did not have an intellectual disability diagnosis in their first year of Medicaid enrollment, receiving an intellectual disability diagnosis later. She also noted that while the co-occurrence of intellectual disability among the autistic population enrolled in Medicaid is common-about 25%-intellectual disability is most often diagnosable in early childhood, especially as children enter school when cognitive testing is delivered more frequently. Because most states don’t have autism-specific criteria for Medicaid eligibility, Carey noted the research team hypothesized, and found, that autistic individuals who experience disruptions in Medicaid coverage-or periods of disenrollment-would be more likely accrue an intellectual disability diagnosis later, because in their home state, their autism diagnosis alone was potentially insufficient for retaining Medicaid coverage. A change to states’ waivers that ensures adequate coverage for autistic people without a co-occurring intellectual disability diagnosis, and ensures continuity in coverage through adulthood, could be an effective approach to mitigate these disruptions to Medicaid coverage-and the need for people to be reexamined for intellectual disability diagnoses in young adulthood, according to the research team. More information: Meghan E Carey et al, Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence, Autism.

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