Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999.

Reyer et al. (2006) looked at Medicaid bills for children with autism from 1994 to 1999. They compared every dollar spent on these kids with dollars spent on other Medicaid children.

Kids with autism cost Medicaid ten times more than typical Medicaid kids. Almost all the extra money went to inpatient psychiatric stays, not to doctor visits.

Gaynor et al. (2008) saw the same cost jump in private plans—four to six times higher—not the full tenfold spike seen here. The gap shows Medicaid kids with autism are the most expensive group.

Cidav et al. (2014) later showed states can cut those high hospital bills. When states spend more on home- and community-based waivers, kids use less inpatient care and more outpatient therapy.

Ohan et al. (2015) flipped the view to families. They found private insurance pushes over five times more out-of-pocket costs onto parents than public Medicaid does. Together the papers draw a clear line: Medicaid bears high system costs but shields families best.

Use these numbers when you fight for waiver slots or outpatient crisis services. Show funders that every dollar moved to community care now can prevent a ten-times-larger hospital bill later.