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Subsidized Contraception, Fertility, and Sexual Behavior

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  • Melissa S. Kearney
  • Phillip B. Levine

Abstract

This paper examines the impact of recent state-level Medicaid policy changes that expanded eligibility for family planning services to higher income women and to Medicaid clients whose benefits would expire otherwise. We begin by establishing that the income-based policy change led to a substantial increase in the number of program recipients. We then examine Vital Statistics birth data from 1990 to 2003 and determine that it also reduced overall births to non-teens by about two percent and to teens by over four percent. Our estimates suggest a nearly nine percent reduction in births to women age 20-44 made eligible by the policy change. We supplement our state-level analysis with an investigation of individual-level data from the 1988, 1995, and 2002 National Surveys of Family Growth (NSFG) to examine the impact of these policies on sexual behavior and contraceptive use. Evidence from this analysis suggests that the reduction in fertility associated with raising income thresholds for eligibility was accomplished via greater use of contraception. Our calculations indicate that allowing higher income women to receive federally-funded family planning cost on the order of $6,800 for each averted birth.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13045.

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Date of creation: Apr 2007
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Publication status: published as 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, October.
Handle: RePEc:nbr:nberwo:13045

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  1. Paul Gertler & John Molyneaux, 1994. "How economic development and family planning programs combined to reduce indonesian fertility," Demography, Springer, vol. 31(1), pages 33-63, February.
  2. Timothy Besley & Anne Case, 1994. "Unnatural Experiments? Estimating the Incidence of Endogenous Policies," NBER Working Papers 4956, National Bureau of Economic Research, Inc.
  3. Paton, David, 2002. "The economics of family planning and underage conceptions," Journal of Health Economics, Elsevier, vol. 21(2), pages 207-225, March.
  4. Jennifer M. Mellor, 1998. "The Effect of Family Planning Programs on the Fertility of Welfare Recipients: Evidence from Medicaid Claims," Journal of Human Resources, University of Wisconsin Press, vol. 33(4), pages 866-895.
  5. Melissa Schettini Kearney, 2004. "Is There an Effect of Incremental Welfare Benefits on Fertility Behavior?: A Look at the Family Cap," Journal of Human Resources, University of Wisconsin Press, vol. 39(2).
  6. Phillip B. Levine, 2001. "The Sexual Activity and Birth-Control Use of American Teenagers," NBER Chapters, in: Risky Behavior among Youths: An Economic Analysis, pages 167-218 National Bureau of Economic Research, Inc.
  7. Martha J Bailey, 2006. "More Power to the Pill: The Impact of Contraceptive Freedom on Women's Life Cycle Labor Supply," The Quarterly Journal of Economics, MIT Press, vol. 121(1), pages 289-320, 02.
  8. Phillip B. Levine, 2002. "The Impact of Social Policy and Economic Activity Throughout the Fertility Decision Tree," NBER Working Papers 9021, National Bureau of Economic Research, Inc.
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Cited by:
  1. Girma, Sourafel & Paton, David, 2011. "The impact of emergency birth control on teen pregnancy and STIs," Journal of Health Economics, Elsevier, vol. 30(2), pages 373-380, March.
  2. Tal Gross & Jeanne Lafortune & Corinne Low, 2012. "What Happens the Morning After? The Costs and Benets of Expanding Access to Emergency Contraception," Documentos de Trabajo 425, Instituto de Economia. Pontificia Universidad Católica de Chile..
  3. Grönqvist, Hans & Hall, Caroline, 2011. "Education policy and early fertility: lessons from an expansion of upper secondary schooling," Working Paper Series 2011:24, IFAU - Institute for Evaluation of Labour Market and Education Policy.
  4. Thomas DeLeire & Leonard Lopoo & Kosali Simon, 2011. "Medicaid Expansions and Fertility in the United States," Demography, Springer, vol. 48(2), pages 725-747, May.
  5. Melissa S. Kearney & Phillip B. Levine, 2007. "Socioeconomic Disadvantage and Early Childbearing," NBER Chapters, in: The Problems of Disadvantaged Youth: An Economic Perspective, pages 181-209 National Bureau of Economic Research, Inc.
  6. Colin Cannonier, . "State Abstinence Education Programs and Teen Fertility in the U.S," Departmental Working Papers 2009-14, Department of Economics, Louisiana State University.
  7. Sourafel Girma & David Paton, 2013. "Does Parental Consent for Birth Control Affect Underage Pregnancy Rates? The Case of Texas," Demography, Springer, vol. 50(6), pages 2105-2128, December.
  8. Colin Cannonier, 2012. "State abstinence education programs and teen birth rates in the US," Review of Economics of the Household, Springer, vol. 10(1), pages 53-75, March.
  9. Mariana Gerstenblüth & Zuleika Ferre & Máximo Rossi & Patricia Triunfo, 2009. "Impacto de la maternidad adolescente en los logros educativos," Documentos de Trabajo (working papers) 0509, Department of Economics - dECON.
  10. Ilyana Kuziemko & Katherine Meckel & Maya Rossin-Slater, 2013. "Do Insurers Risk-Select Against Each Other? Evidence from Medicaid and Implications for Health Reform," NBER Working Papers 19198, National Bureau of Economic Research, Inc.

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