Association for Public Policy Analysis & Management

The Supplemental Security Income (SSI) program provides cash assistance to low-income children with disabilities, expanding family budgets and potentially allowing low-income parents to better protect the health of vulnerable children. Our study is one of the first to estimate the causal impacts of SSI on child health outcomes and medical expenditures. Starting in 1993, birthweight less than 1,200 grams became a presumptive disability category of SSI. We exploit this threshold in a regression discontinuity design by using New York State Medicaid claims data. The low birthweight cutoff increases the probability of SSI enrollment by 93% until age one. In early childhood (before age 6), children eligible for SSI are less likely to suffer from both acute (infection, injury) and chronic (malnutrition, developmental delay) conditions, and have a decreased probability of hospital admission. Children eligible for SSI have 30% lower Medicaid costs by age 8 than children born just above the threshold. SSI eligibility reduces the number of new chronic conditions by 15% until age 3. Past health shocks significantly increase current healthcare utilization, but an interaction term between the SSI eligibility and past health shocks is not statistically significant, indicating that SSI does not change how families respond to health shocks, but reduces the probability that a child is subject to health shocks in early life. We also find that children eligible for SSI also live in higher income neighborhoods by age 8, mainly because their families are less likely to move out of such neighborhoods.