Insurance commissioner warns of rising costs and budgetary obligations for autism coverage; market pressures drive higher auto and homeowners premiums

John Pike, Utah insurance commissioner, told the committee June 18 that the department submitted a proposed update to Utah’s essential health benefit benchmark plan to the Centers for Medicare & Medicaid Services on May 7 so the autism coverage state mandate could be folded into the benchmark instead of being paid from state funds. "If they accept the proposal then it would apply to plan years starting 01/01/2027," Pike said, and the department estimates the current deferred payments the state will owe carriers will decline if CMS approves the change.

Pike described the growth in deferred payments tied to the autism mandate and presented estimates from the department’s actuary: payments the state made in early years were modest but have grown (the department cited $1.4 million for earlier years and later-year claims that led to larger deferred payments), and the department estimated future fiscal-year obligations of increasing amounts for costs incurred in recent years.…