IDEAS home Printed from https://ideas.repec.org/a/wly/jpamgt/v42y2023i4p1045-1064.html
   My bibliography  Save this article

Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives

Author

Listed:
  • Barton Willage
  • Marisa Carlos
  • Kevin Callison

Abstract

We use changes to Medicaid immediate postpartum policy to test whether non‐monetary costs are meaningful obstacles to health care. Medicaid in several states currently covers long‐acting reversible contraceptives (LARCs, including IUDs and implants) immediately following delivery of a child, eliminating much of the time‐cost and stress associated with obtaining a LARC. Postpartum LARCs can reduce unintended and short‐interval pregnancies, which are associated with adverse neonatal outcomes. Births that occur in Catholic‐owned hospitals are an ideal control group, because these hospitals are prohibited from offering family‐planning services, including LARCs. Using difference‐in‐differences and individual‐level administrative data from Louisiana and New York, we find eliminating non‐monetary obstacles increases take‐up of a high‐value and highly effective form of contraception. Additionally, we find no evidence of crowd‐out of outpatient LARCs.

Suggested Citation

  • Barton Willage & Marisa Carlos & Kevin Callison, 2023. "Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(4), pages 1045-1064, September.
    • Handle: RePEc:wly:jpamgt:v:42:y:2023:i:4:p:1045-1064
    DOI: 10.1002/pam.22504
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/pam.22504
    Download Restriction: no
    File URL: https://libkey.io/10.1002/pam.22504?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. Hill, Elaine L. & Slusky, David J.G. & Ginther, Donna K., 2019. "Reproductive health care in Catholic-owned hospitals," Journal of Health Economics, Elsevier, vol. 65(C), pages 48-62.
    3. repec:mpr:mprres:7725 is not listed on IDEAS
    4. Tal Gross & Jeanne Lafortune & Corinne Low, 2014. "What Happens the Morning After? The Costs and Benefits of Expanding Access to Emergency Contraception," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 70-93, January.
    5. Melissa S. Kearney & Phillip B. Levine, 2009. "Subsidized Contraception, Fertility, and Sexual Behavior," The Review of Economics and Statistics, MIT Press, vol. 91(1), pages 137-151, February.
    6. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    7. Fischer, Stefanie & Royer, Heather & White, Corey, 2018. "The impacts of reduced access to abortion and family planning services on abortions, births, and contraceptive purchases," Journal of Public Economics, Elsevier, vol. 167(C), pages 43-68.
    8. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
    9. Nora V. Becker, 2018. "The Impact of Insurance Coverage on Utilization of Prescription Contraceptives: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 37(3), pages 571-601, June.
    10. Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 334-359, Summer.
    11. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    12. Jason M. Lindo & Analisa Packham, 2017. "How Much Can Expanding Access to Long-Acting Reversible Contraceptives Reduce Teen Birth Rates?," American Economic Journal: Economic Policy, American Economic Association, vol. 9(3), pages 348-376, August.
    13. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    14. Yao Lu & David J. G. Slusky, 2016. "The Impact of Women's Health Clinic Closures on Preventive Care," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 100-124, July.
    15. Shigeoka, Hitoshi & Fushimi, Kiyohide, 2014. "Supplier-induced demand for newborn treatment: Evidence from Japan," Journal of Health Economics, Elsevier, vol. 35(C), pages 162-178.
    16. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    17. Christine Piette Durrance, 2013. "The Effects Of Increased Access To Emergency Contraception On Sexually Transmitted Disease And Abortion Rates," Economic Inquiry, Western Economic Association International, vol. 51(3), pages 1682-1695, July.
    18. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    19. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    20. Stefan Pichler & Katherine Wen & Nicolas R. Ziebarth, 2021. "Positive Health Externalities of Mandating Paid Sick Leave," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 715-743, June.
    21. Jones, R.K. & Jerman, J., 2017. "Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014," American Journal of Public Health, American Public Health Association, vol. 107(12), pages 1904-1909.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fischer, Stefanie & Royer, Heather & White, Corey, 2018. "The impacts of reduced access to abortion and family planning services on abortions, births, and contraceptive purchases," Journal of Public Economics, Elsevier, vol. 167(C), pages 43-68.
    2. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    3. Martha J. Bailey & Jason M. Lindo, 2017. "Access and Use of Contraception and Its Effects on Women’s Outcomes in the U.S," NBER Working Papers 23465, National Bureau of Economic Research, Inc.
    4. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    5. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2022. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," NBER Working Papers 30663, National Bureau of Economic Research, Inc.
    6. Fischer, Stefanie & Royer, Heather & White, Corey, 2017. "The Impacts of Reduced Access to Abortion and Family Planning Services: Evidence from Texas," IZA Discussion Papers 10920, Institute of Labor Economics (IZA).
    7. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    8. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
    9. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    10. Kelly, Andrea & Lindo, Jason M. & Packham, Analisa, 2020. "The power of the IUD: Effects of expanding access to contraception through Title X clinics," Journal of Public Economics, Elsevier, vol. 192(C).
    11. Dolores De La Mata, 2012. "The Effect Of Medicaid Eligibility On Coverage, Utilization, And Children'S Health," Health Economics, John Wiley & Sons, Ltd., vol. 21(9), pages 1061-1079, September.
    12. Véra Zabrodina & Mark Dusheiko & Karine Moschetti, 2020. "A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1566-1585, December.
    13. Heike Hennig‐Schmidt & Hendrik Jürges & Daniel Wiesen, 2019. "Dishonesty in health care practice: A behavioral experiment on upcoding in neonatology," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 319-338, March.
    14. Andrey Aistov & Ekaterina Aleksandrova & Christopher J. Gerry, 2021. "Voluntary private health insurance, health-related behaviours and health outcomes: evidence from Russia," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 281-309, March.
    15. Joanna Venator & Jason Fletcher, 2021. "Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 774-813, June.
    16. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    17. Thompson, Owen, 2017. "The long-term health impacts of Medicaid and CHIP," Journal of Health Economics, Elsevier, vol. 51(C), pages 26-40.
    18. Hayen, Arthur P. & Klein, Tobias J. & Salm, Martin, 2021. "Does the framing of patient cost-sharing incentives matter? the effects of deductibles vs. no-claim refunds," Journal of Health Economics, Elsevier, vol. 80(C).
    19. Lipton, Brandy J. & Decker, Sandra L., 2015. "The effect of health insurance coverage on medical care utilization and health outcomes: Evidence from Medicaid adult vision benefits," Journal of Health Economics, Elsevier, vol. 44(C), pages 320-332.
    20. Martha J. Bailey & Lea Bart & Vanessa Wanner Lang, 2022. "The Missing Baby Bust: The Consequences of the COVID-19 Pandemic for Contraceptive Use, Pregnancy, and Childbirth Among Low-Income Women," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(4), pages 1549-1569, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jpamgt:v:42:y:2023:i:4:p:1045-1064. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/journal/34787/home .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.