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Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives

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  • Barton Willage
  • Marisa Carlos
  • Kevin Callison

Abstract

We use changes to Medicaid immediate postpartum policy to test whether non‐monetary costs are meaningful obstacles to health care. Medicaid in several states currently covers long‐acting reversible contraceptives (LARCs, including IUDs and implants) immediately following delivery of a child, eliminating much of the time‐cost and stress associated with obtaining a LARC. Postpartum LARCs can reduce unintended and short‐interval pregnancies, which are associated with adverse neonatal outcomes. Births that occur in Catholic‐owned hospitals are an ideal control group, because these hospitals are prohibited from offering family‐planning services, including LARCs. Using difference‐in‐differences and individual‐level administrative data from Louisiana and New York, we find eliminating non‐monetary obstacles increases take‐up of a high‐value and highly effective form of contraception. Additionally, we find no evidence of crowd‐out of outpatient LARCs.

Suggested Citation

  • Barton Willage & Marisa Carlos & Kevin Callison, 2023. "Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(4), pages 1045-1064, September.
    • Handle: RePEc:wly:jpamgt:v:42:y:2023:i:4:p:1045-1064
    DOI: 10.1002/pam.22504
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    References listed on IDEAS

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    1. Shigeoka, Hitoshi & Fushimi, Kiyohide, 2014. "Supplier-induced demand for newborn treatment: Evidence from Japan," Journal of Health Economics, Elsevier, vol. 35(C), pages 162-178.
    2. Fischer, Stefanie & Royer, Heather & White, Corey, 2018. "The impacts of reduced access to abortion and family planning services on abortions, births, and contraceptive purchases," Journal of Public Economics, Elsevier, vol. 167(C), pages 43-68.
    3. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    4. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    5. repec:bla:ecinqu:v:51:y:2013:i:3:p:1682-1695 is not listed on IDEAS
    6. Hill, Elaine L. & Slusky, David J.G. & Ginther, Donna K., 2019. "Reproductive health care in Catholic-owned hospitals," Journal of Health Economics, Elsevier, vol. 65(C), pages 48-62.
    7. David Card & Carlos Dobkin & Nicole Maestas, 2008. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization: Evidence from Medicare," American Economic Review, American Economic Association, vol. 98(5), pages 2242-2258, December.
    8. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    9. Stefan Pichler & Katherine Wen & Nicolas R. Ziebarth, 2021. "Positive Health Externalities of Mandating Paid Sick Leave," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 715-743, June.
    10. repec:mpr:mprres:7725 is not listed on IDEAS
    11. Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 334-359, Summer.
    12. Tal Gross & Jeanne Lafortune & Corinne Low, 2014. "What Happens the Morning After? The Costs and Benefits of Expanding Access to Emergency Contraception," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 33(1), pages 70-93, January.
    13. 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, February.
    14. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
    15. Jones, R.K. & Jerman, J., 2017. "Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014," American Journal of Public Health, American Public Health Association, vol. 107(12), pages 1904-1909.
    16. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    17. Nora V. Becker, 2018. "The Impact of Insurance Coverage on Utilization of Prescription Contraceptives: Evidence from the Affordable Care Act," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 37(3), pages 571-601, June.
    18. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    19. Jason M. Lindo & Analisa Packham, 2017. "How Much Can Expanding Access to Long-Acting Reversible Contraceptives Reduce Teen Birth Rates?," American Economic Journal: Economic Policy, American Economic Association, vol. 9(3), pages 348-376, August.
    20. Currie, Janet & Decker, Sandra & Lin, Wanchuan, 2008. "Has public health insurance for older children reduced disparities in access to care and health outcomes?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1567-1581, December.
    21. Yao Lu & David J. G. Slusky, 2016. "The Impact of Women's Health Clinic Closures on Preventive Care," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 100-124, July.
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