"Everyone should at least get a Kia": Policymaker perspectives on equity of Medicaid among transition age autistic youth

Abstract

Background: This study examined the challenges faced by transition age autistic youth in accessing Medicaid services, considering the historical focus on children in autism research and services. The study aimed to explore Medicaid enrollment and support for this population. Method: The study involved Medicaid and Protection & Advocacy (P&A) representatives from states with varying performance levels in eligibility, access, and service use. Discussions with experts focused on waivers, Early, Periodic, Screening, Detection, and Treatment (EPSDT), and barriers to service access. Results: The findings highlighted the need to improve service access for transition age autistic youth. States identified the importance of maximizing EPDST utilization before aging out of childhood systems and pursuing waiver enrollment. These insights emphasized the significance of addressing service gaps during the transition to adulthood. Conclusions: The study's implications for practice are substantial. Policymakers and service providers must acknowledge the limitedservice access for autistic individuals as they transition from child systems. The study emphasized the value of strategies like maximizing EPDST utilization and pursuing waivers to ensure ongoing support for autistic youth during their transition to adulthood. By addressing these challenges, practitioners can better meet the needs of transition age autistic individuals and facilitate their access to essential services.