Do Health Insurance Mandates Spillover to Education? Evidence from Michigan's Autism Insurance Mandate
Social programs and mandates are usually studied in isolation, but interaction effects could create spillovers to other public goods. We examine how health insurance coverage affects the education of students with Autism Spectrum Disorder (ASD) in the context of state-mandated private therapy coverage. Since Medicaid benefits under the mandate were far weaker than under private insurance, we proxy for Medicaid ineligibility and estimate effects via triple-differences. While we find little change in ASD identification, the mandate crowds-out special education supports for students with ASD by shifting students to less restrictive environments and reducing the use of ASD specialized teacher consultants. A lack of short-run impact on achievement supports our interpretation of the service reductions as crowd-out and indicates that the shift does not academically harm students with ASD.
We would like to thank the Michigan Department of Education and the Center for Educational Performance Information for their assistance in getting this project started, providing data, and technical support. We would also like to thank Marika Cabral, David Figlio, Nora Gordon, and seminar participants at the Institute for Poverty Research at the University of Wisconsin, Association for Education Finance and Policy and Association for Public Policy Analysis and Management meetings. Research assistance by Alyssa Carlson is also greatly appreciated. This research result used data collected and maintained by the Michigan Department of Education (MDE) and/or Michigan's Center for Educational Performance and Information (CEPI). Results, information and opinions solely represent the analysis, information and opinions of the author(s) and are not endorsed by, or reflect the views or positions of, grantors, MDE and CEPI, or any employee thereof. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.