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The Effect Of State Insurance Mandates On Infant Immunization Rates

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  • Lenisa V. Chang

Abstract

While US infant immunization rates have been increasing in the last 20 years, the cost of fully immunizing a child with all recommended vaccines has almost tripled. This is partly not only due to new additions in the list of recommended vaccines but also due to the use of new, safer, but more expensive technologies in vaccine production and distribution. In recent years, many states have mandated that recommended childhood vaccines be covered by private health insurance companies. Currently, there are 33 states with such a mandate. In this paper, I examine whether the introduction of mandates on private insurers affected immunization rates. Using state and time variation, I find that mandates increased the immunization rate for three vaccines—the diphtheria–tetanus–pertussis, polio, and measles–mumps–rubella vaccines—by about 1.8 percentage points. These results may provide a lower bound for the expected effect of the Affordable Care Act, which mandates coverage of childhood vaccines for all private insurers in the USA. I also find evidence that the mandates shifted a significant portion of vaccinations from publicly funded sources to private ones, with a decline in public health clinic visits and an increase in vaccinations at hospitals and doctor's offices. Copyright © 2015 John Wiley & Sons, Ltd.

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  • Lenisa V. Chang, 2016. "The Effect Of State Insurance Mandates On Infant Immunization Rates," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 372-386, March.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:3:p:372-386
    DOI: 10.1002/hec.3153
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    1. Rajeev Dehejia & Adriana Lleras-Muney, 2004. "Booms, Busts, and Babies' Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(3), pages 1091-1130.
    2. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    3. repec:pri:cheawb:adriana_booms.pdf is not listed on IDEAS
    4. Papke, Leslie E. & Wooldridge, Jeffrey M., 2008. "Panel data methods for fractional response variables with an application to test pass rates," Journal of Econometrics, Elsevier, vol. 145(1-2), pages 121-133, July.
    5. Anderberg, Dan & Chevalier, Arnaud & Wadsworth, Jonathan, 2011. "Anatomy of a health scare: Education, income and the MMR controversy in the UK," Journal of Health Economics, Elsevier, vol. 30(3), pages 515-530, May.
    6. Jonathan Klick & Sara Markowitz, 2006. "Are mental health insurance mandates effective? Evidence from suicides," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 83-97, January.
    7. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    8. Schmidt, Lucie, 2007. "Effects of infertility insurance mandates on fertility," Journal of Health Economics, Elsevier, vol. 26(3), pages 431-446, May.
    9. Matthew Lang, 2013. "The Impact Of Mental Health Insurance Laws On State Suicide Rates," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 73-88, January.
    10. John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24, February.
    11. repec:pri:cheawb:adriana_booms is not listed on IDEAS
    12. Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
    13. Abrevaya, Jason & Mulligan, Karen, 2011. "Effectiveness of state-level vaccination mandates: Evidence from the varicella vaccine," Journal of Health Economics, Elsevier, vol. 30(5), pages 966-976.
    14. Rein, D.B. & Honeycutt, A.A. & Rojas-Smith, L. & Hersey, J.C., 2006. "Impact of the CDC's Section 317 immunization grants program funding on childhood vaccination coverage," American Journal of Public Health, American Public Health Association, vol. 96(9), pages 1548-1553.
    15. Moulton, Brent R, 1990. "An Illustration of a Pitfall in Estimating the Effects of Aggregate Variables on Micro Unit," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 334-338, May.
    16. Davis, M.M. & Zimmerman, J.L. & Wheeler, J.R.C. & Freed, G.L., 2002. "Childhood vaccine purchase costs in the public sector: Past trends, future expectations," American Journal of Public Health, American Public Health Association, vol. 92(12), pages 1982-1987.
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    2. Lawler, Emily C., 2017. "Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine," Journal of Health Economics, Elsevier, vol. 52(C), pages 45-62.
    3. Lenisa V. Chang, 2018. "Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1043-1062, July.
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    7. Shen, Yichen & Noguchi, Haruko, 2021. "Impacts of anticancer drug parity laws on mortality rates," Social Science & Medicine, Elsevier, vol. 272(C).

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