TABLE 1

Adjusted Average Monthly Out-of-Pocket Spending, Insurer Spending, and Share of Spending Paid Out of Pocket for ASD-Specific Services by Spending Quintile, 2008–2012

Mandate EligibleMandate IneligibleChange Attributable to Mandates
Mandate in PlaceNo Mandate in PlaceMandate in PlaceNo Mandate in Place
Quintile 1 (lowest spenders)
 Out-of-pocket spending, $514946440
 Insurer spending, $757084834
 Share of out-of-pocket spending, %464639401
Quintile 2
 Out-of-pocket spending, $676560601
 Insurer spending, $1089411911510**
 Share of out-of-pocket spending, %45473940−1
Quintile 3
 Out-of-pocket spending, $908979780
 Insurer spending, $1481321731669*
 Share of out-of-pocket spending, %44463738−1
Quintile 4
 Out-of-pocket spending, $130134117111−10**
 Insurer spending, $263265311307−5
 Share of out-of-pocket spending, %41423535−1
Quintile 5 (highest spenders)
 Out-of-pocket spending, $30726221920935***
 Insurer spending, $1657141512111239270***
 Share of out-of-pocket spending, %28322727−4***
  • The final sample included 106 977 children. Quintiles were determined by average monthly spending on ASD-specific services between 2008 and 2012. Spending measures were adjusted for sex, age, insurance plan type, and state, month, and year fixed effects. SEs were clustered at the child level. Mandate eligible refers to whether the child had a fully insured plan and met the age criteria for the state’s mandate in a given month. Mandate in place refers to whether the child’s state had a mandate in place in a given month. Children may contribute months to multiple columns.

  • *** P < .001

  • ** P < .01

  • * P < .05.