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The effect of Medicaid eligibility expansions on fertility

  • Zavodny, Madeline
  • Bitler, Marianne P.

In the United States, pregnant women and children's eligibility for Medicaid was expanded dramatically during the 1980s and early 1990s. By lowering pregnancy and child health care costs, the Medicaid expansions may have increased the incentives for women to have children. To investigate this possibility, we examine whether state-level birth and abortion rates are related to the extent of states' Medicaid eligibility expansions and the fraction of women eligible for Medicaid, controlling for economic and demographic factors, during the period 1982 to 1996. We examine birth rates by race, marital status and education as well as overall abortion rates. We find little evidence that the Medicaid expansions led to changes in birth rates or abortion rates. However, some results do suggest that the Medicaid expansions boosted the birth rate among white women who have not completed high school. We find that restrictions on Medicaid funding of abortions decrease abortion rates and increase birth rates. The results thus do not provide definitive evidence that expansions in public health insurance eligibility have sizable effects on women's fertility.

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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 71 (2010)
Issue (Month): 5 (September)
Pages: 918-924

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Handle: RePEc:eee:socmed:v:71:y:2010:i:5:p:918-924
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  1. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December.
  2. Arleen Leibowitz, 1990. "The Response of Births to Changes in Health Care Costs," Journal of Human Resources, University of Wisconsin Press, vol. 25(4), pages 697-711.
  3. Aaron Yelowitz, 1995. "The Medicaid Notch, Labor Supply and Welfare Participation: Evidence from Eligibility Expansions," UCLA Economics Working Papers 738, UCLA Department of Economics.
  4. John C. Ham & Lara D. Shore-Sheppard, 2005. "Did Expanding Medicaid Affect Welfare Participation?," ILR Review, Cornell University, ILR School, vol. 58(3), pages 452-470, April.
  5. Blank, Rebecca M. & George, Christine C. & London, Rebecca A., 1996. "State abortion rates the impact of policies, providers, politics, demographics, and economic environment," Journal of Health Economics, Elsevier, vol. 15(5), pages 513-553, October.
  6. Janet Currie & Jeffrey Grogger, 2000. "Medicaid Expansions and Welfare Contractions: Offsetting Effects on Prenatal Care and Infant Health?," NBER Working Papers 7667, National Bureau of Economic Research, Inc.
  7. Theodore Joyce & Robert Kaestner, 1996. "The effect of expansions in medicaid income eligibility on abortion," Demography, Springer;Population Association of America (PAA), vol. 33(2), pages 181-192, May.
  8. David Card & Lara D. Shore-Sheppard, 2003. "Using Discontinuous Eligibility Rules to Identify the Effects of the Federal Medicaid Expansions on Low Income Children," Department of Economics Working Papers 2003-09, Department of Economics, Williams College.
  9. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc.
  10. Deborah Haas-Wilson, 1993. "The economic impact of state restrictions on abortion: Parental consent and notification laws and medicaid funding restrictions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 12(3), pages 498-511.
  11. Jacob Alex Klerman, 1999. "U.S. Abortion Policy and Fertility," American Economic Review, American Economic Association, vol. 89(2), pages 261-264, May.
  12. Thomas J. Kane & Douglas Staiger, 1996. "Teen Motherhood and Abortion Access," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 467-506.
  13. Gary S. Becker, 1960. "An Economic Analysis of Fertility," NBER Chapters, in: Demographic and Economic Change in Developed Countries, pages 209-240 National Bureau of Economic Research, Inc.
  14. David M. Cutler & Jonathan Gruber, 1996. "Does Public Insurance Crowd out Private Insurance?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 391-430.
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