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Utilization of Infertility Treatments: The Effects of Insurance Mandates

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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 care 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 for a specific subgroup in the population: older, highly educated women. These women are both at high risk for fertility problems, and have high rates of coverage by insurance plans affected by the mandates. We find robust evidence that while an effect of the mandates on utilization can not be found for the full population of women, the mandates do have a large and significant effect on utilization for exactly this subgroup.

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Paper provided by Department of Economics, Williams College in its series Department of Economics Working Papers with number 2008-05.

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Length: 26 pages
Date of creation: Apr 2008
Date of revision:
Publication status: forthcoming in Demography.
Handle: RePEc:wil:wileco:2008-05

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  1. Paul Oyer, 2005. "Salary or Benefits?," NBER Working Papers 11817, National Bureau of Economic Research, Inc.
  2. Blackburn, McKinley L & Bloom, David E & Neumark, David, 1993. "Fertility Timing, Wages, and Human Capital," Journal of Population Economics, Springer, vol. 6(1), pages 1-30.
  3. Amalia Miller, 2011. "The effects of motherhood timing on career path," Journal of Population Economics, Springer, vol. 24(3), pages 1071-1100, July.
  4. M. Kate Bundorf & Natalie Chun & Gopi Shah Goda & Daniel P. Kessler, 2008. "Do Markets Respond to Quality Information? The Case of Fertility Clinics," NBER Working Papers 13888, National Bureau of Economic Research, Inc.
  5. Timothy Conley & Christopher Taber, 2005. "Inference with "Difference in Differences" with a Small Number of Policy Changes," NBER Technical Working Papers 0312, National Bureau of Economic Research, Inc.
  6. Rothschild, Michael & Stiglitz, Joseph E, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, MIT Press, vol. 90(4), pages 630-49, November.
  7. Robert Kaestner & Kosali Ilayperuma Simon, 2002. "Labor market consequences of state health insurance regulation," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 56(1), pages 136-159, October.
  8. Marianne Bitler & Madeline Zavodny, 2000. "The effect of Medicaid eligibility expansions on births," Working Paper 2000-4, Federal Reserve Bank of Atlanta.
  9. Schmidt, Lucie, 2007. "Effects of infertility insurance mandates on fertility," Journal of Health Economics, Elsevier, vol. 26(3), pages 431-446, May.
  10. Gruber, Jonathan, 1994. "State-mandated benefits and employer-provided health insurance," Journal of Public Economics, Elsevier, vol. 55(3), pages 433-464, November.
  11. M. Kate Bundorf & Melinda Henne & Laurence Baker, 2007. "Mandated Health Insurance Benefits and the Utilization and Outcomes of Infertility Treatments," NBER Working Papers 12820, National Bureau of Economic Research, Inc.
  12. Marianne P. Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandate," Working Papers 330, RAND Corporation Publications Department.
  13. Rajeev Dehejia & Adriana Lleras-Muney, 2004. "Booms, Busts, and Babies’ Health," Working Papers 250, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
  14. 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.
  15. Marianne P. Bitler & Christopher S. Carpenter, 2011. "Insurance Mandates and Mammography," NBER Working Papers 16669, National Bureau of Economic Research, Inc.
  16. Liu, Zhimei & Dow, William H. & Norton, Edward C., 2004. "Effect of drive-through delivery laws on postpartum length of stay and hospital charges," Journal of Health Economics, Elsevier, vol. 23(1), pages 129-155, January.
  17. Jane Menken, 1985. "Age and fertility: How late can you wait?," Demography, Springer, vol. 22(4), pages 469-483, November.
  18. Zavodny, Madeline & Bitler, Marianne P., 2010. "The effect of Medicaid eligibility expansions on fertility," Social Science & Medicine, Elsevier, vol. 71(5), pages 918-924, September.
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Cited by:
  1. Machado, Matilde Pinto & Sanz-de-Galdeano, Anna, 2011. "Coverage of Infertility Treatment and Fertility Outcomes: Do Women Catch Up?," CEPR Discussion Papers 8445, C.E.P.R. Discussion Papers.
  2. 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.

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