Billing Codes and Body Bags: How Administrative Data Became the Only Record of a Population the System Refuses to Seriously Study

When the data come from claims and the conclusions come from press releases, the Autism epidemic stays invisible and the causes stay unexamined.

By Peter A. McCullough, MD, MPH

For some of my adult patients with profound autism, life seemingly can be grim with group home residency, 24 x 7 care and uncertain medical outcomes. One of my fears was confirmed by this recent paper.

Article Review: Li et al., Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries, JAMA Network Open 2026

Journal: JAMA Network Open (published September 10, 2026) Lead author: Guohua Li, DrPH, MD (Columbia Mailman School of Public Health), with Carolyn DiGuiseppi (University of Colorado Anschutz) and colleagues

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🧾 What the Paper Actually Did

This is a cross-sectional analysis of administrative claims data—not a clinical study. The authors pulled from:

• Transformed Medicaid Statistical Information System (T-MSIS) and CHIP data

• Linked to the National Death Index for beneficiaries in all 50 states + DC, 2000–2020

Cohort size: 2,048,046 Medicaid beneficiaries coded with ASD; 18,268 deaths recorded. The cohort was 76% male, 49% non-Hispanic White.

Headline findings:

Causes of excess death (sex-standardized mortality ratios):

• Influenza — SMR 10.55 (the standout)

• Malnutrition — SMR 7.56

• Pneumonitis from inhaled solids/liquids — SMR 6.92

• Non-vehicle accidents — SMR 4.48

• Drowning — SMR 3.26

• Pneumonia — SMR 3.06

Sobering point-of-view: life expectancy for this population “is the same as for the general population in Haiti or Angola.”