Autism and families' financial burden: the association with health insurance coverage.

Ohan et al. (2015) asked parents about the money they paid themselves for a child with autism.

They compared families who used private insurance with families who used public insurance.

Families told them how much cash they spent out-of-pocket and what they earned in a year.

Private-insurance families were over five times more likely to have big out-of-pocket bills.

For every $1,000 a family earned, they paid about $9.70 themselves.

Public insurance left families with far smaller bills to cover alone.

Goodwin et al. (2012) already showed that states spending more Medicaid money per child cut family costs.

The new study flips the lens: even when kids are insured, private plans push costs back on families.

Gaynor et al. (2008) found total medical spending for privately-insured kids with ASD is 4–6× higher than typical kids.

That big total bill now makes sense—families, not the plan, are picking up much of it.

Roddy et al. (2019) in Ireland saw the same pattern: families paid twice what the state paid.

The story holds across countries: public coverage shields families; private coverage does not.

When you write a treatment plan, know that a family on private insurance may quietly skip sessions because each co-pay hurts.

Offer to help them switch to Medicaid or a waiver if they qualify, or to schedule fewer but longer sessions to cut daily co-pays.

Share these numbers with employers and insurers when you advocate for better ABA benefits—evidence shows the burden is real and measurable.