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Utilization of Infertility Treatments: The Effects of Insurance Mandates

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  • Marianne P. Bitler
  • Lucie Schmidt

Abstract

Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health insurance plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this paper, we examine whether mandated insurance coverage for infertility treatment affects utilization. We allow utilization effects to differ by age and education, since previous research suggests that older, more educated women should be more likely to be directly affected by the mandates than younger women and less educated women, both because they are at higher risk of fertility problems and because they are more likely to have private health insurance which is subject to the mandate. We find robust evidence that the mandates do have a significant effect on utilization for older, more educated women that is larger than the effects found for other groups. These effects are largest for the use of ovulation-inducing drugs and artificial insemination.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 17668.

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Date of creation: Dec 2011
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Publication status: published as Marianne Bitler & Lucie Schmidt, 2012. "Utilization of Infertility Treatments: The Effects of Insurance Mandates," Demography, Springer, vol. 49(1), pages 125-149, February.
Handle: RePEc:nbr:nberwo:17668

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References

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  1. Timothy G. Conley & Christopher R. Taber, 2011. "Inference with "Difference in Differences" with a Small Number of Policy Changes," The Review of Economics and Statistics, MIT Press, vol. 93(1), pages 113-125, February.
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  9. Gruber, Jonathan, 1994. "State-mandated benefits and employer-provided health insurance," Journal of Public Economics, Elsevier, vol. 55(3), pages 433-464, November.
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  13. Marianne Bitler & Lucie Schmidt, 2006. "Health disparities and infertility: impacts of state-level insurance mandates," Department of Economics Working Papers 2006-04, Department of Economics, Williams College, revised Nov 2006.
  14. Marianne Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandates," PPIC Working Papers 2005.06, Public Policy Institute of California.
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Cited by:
  1. Joelle Abramowitz, 2014. "Turning back the ticking clock: the effect of increased affordability of assisted reproductive technology on women’s marriage timing," Journal of Population Economics, Springer, vol. 27(2), pages 603-633, April.
  2. Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2011. "Coverage of Infertility Treatment and Fertility Outcomes: Do Women Catch Up?," IZA Discussion Papers 5783, Institute for the Study of Labor (IZA).

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