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Pregnancy Medicaid Expansions and Fertility: Differentiating between the Intensive and Extensive Margins

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Abstract

The theoretical and empirical links between public health insurance access and fertility in the United States remain unclear. Utilizing a demographic cell-based estimation approach with panel data (1987-1997), we revisit the large-scale Medicaid expansions to pregnant women during the 1980s to estimate the heterogeneous impacts of public health insurance access on childbirth. While the decision to become a parent (i.e., the extensive margin) appears to be unaffected by increased access to Medicaid, we find that increased access to public health insurance positively influenced the number of high parity births (i.e., the intensive margin) for select groups of women. In particular, we find a robust, positive birth effect for unmarried women with a high school education, a result which is consistent across the two racial groups examined in our analysis: African American and white women. This result suggests that investigating effects along both the intensive and extensive margin is important for scholars who study the natalist effects of social welfare policies, and our evidence provides a more nuanced understanding of the influence of public health insurance on fertility.

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  • Lincoln Groves & Sarah Hamersma & Leonard M. Lopoo, 2017. "Pregnancy Medicaid Expansions and Fertility: Differentiating between the Intensive and Extensive Margins," Center for Policy Research Working Papers 206, Center for Policy Research, Maxwell School, Syracuse University.
  • Handle: RePEc:max:cprwps:206
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    Cited by:

    1. Guldi, Melanie & Hamersma, Sarah, 2023. "The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health," Journal of Health Economics, Elsevier, vol. 87(C).
    2. Sarah Miller & Laura Wherry, 2022. "Covering Undocumented Immigrants: The Effects of a Large-Scale Prenatal Care Intervention," Working Papers 22-28, Center for Economic Studies, U.S. Census Bureau.
    3. Janna Bergsvik & Agnes Fauske & Rannveig Kaldager Hart, 2021. "Can Policies Stall the Fertility Fall? A Systematic Review of the (Quasi‐) Experimental Literature," Population and Development Review, The Population Council, Inc., vol. 47(4), pages 913-964, December.
    4. Malte Sandner & Frederik Wiynck, 2023. "The Fertility Response to Cutting Child-Related Welfare Benefits," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(2), pages 1-29, April.
    5. Sarah Hamersma & Yilin Hou & Yusun Kim & Douglas Wolf, 2018. "Business Cycles, Medicaid Generosity, and Birth Outcomes," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(5), pages 729-749, October.
    6. Janna Bergsvik & Agnes Fauske & Rannveig K. Hart, 2020. "Effects of policy on fertility. A systematic review of (quasi)experiments," Discussion Papers 922, Statistics Norway, Research Department.

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    More about this item

    Keywords

    Medicaid; Fertility; Parity;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

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