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Utilization of Infertility Treatments: The Effects of Insurance Mandates

  • Marianne Bitler
  • Lucie Schmidt

    ()

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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File URL: http://hdl.handle.net/10.1007/s13524-011-0078-4
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Article provided by Springer & Population Association of America (PAA) in its journal Demography.

Volume (Year): 49 (2012)
Issue (Month): 1 (February)
Pages: 125-149

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Handle: RePEc:spr:demogr:v:49:y:2012:i:1:p:125-149
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Web page: http://www.populationassociation.org/

Order Information: Web: http://www.springer.com/economics/journal/13524

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  1. Oyer, Paul, 2004. "Salary or Benefits?," Santa Cruz Department of Economics, Working Paper Series qt8xs3k3j8, Department of Economics, UC Santa Cruz.
  2. Marianne Bitler & Madeline Zavodny, 2000. "The effect of Medicaid eligibility expansions on births," FRB Atlanta Working Paper 2000-4, Federal Reserve Bank of Atlanta.
  3. 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.
  4. Lucie Schmidt, 2005. "Effects of Infertility Insurance Mandates on Fertility," Department of Economics Working Papers 2005-07, Department of Economics, Williams College.
  5. Jane Menken, 1985. "Age and fertility: How late can you wait?," Demography, Springer;Population Association of America (PAA), vol. 22(4), pages 469-483, November.
  6. Blackburn, McKinley L & Bloom, David E & Neumark, David, 1993. "Fertility Timing, Wages, and Human Capital," Journal of Population Economics, Springer;European Society for Population Economics, vol. 6(1), pages 1-30.
  7. 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..
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  9. repec:pri:cheawb:adriana_booms is not listed on IDEAS
  10. Robert Kaestner & Kosali Ilayperuma Simon, 2002. "Labor Market Consequences of State Health Insurance Regulation," ILR Review, Cornell University, ILR School, vol. 56(1), pages 136-159, October.
  11. Amalia Miller, 2011. "The effects of motherhood timing on career path," Journal of Population Economics, Springer;European Society for Population Economics, vol. 24(3), pages 1071-1100, July.
  12. 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.
  13. 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.
  14. Gruber, Jonathan, 1994. "State-mandated benefits and employer-provided health insurance," Journal of Public Economics, Elsevier, vol. 55(3), pages 433-464, November.
  15. 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.
  16. 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.
  17. 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.
  18. Marianne P. Bitler & Christopher S. Carpenter, 2011. "Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses," NBER Working Papers 16669, National Bureau of Economic Research, Inc.
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