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The Effect of Family Planning Programs on the Fertility of Welfare Recipients: Evidence from Medicaid Claims

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  • Jennifer M. Mellor

Abstract

Can public programs effectively reduce the number of births to women on public assistance? In this paper, I examine the provision of family planning services to welfare recipients through the Medicaid program. Previous studies of publicly-funded family planning services in the U.S. have produced conflicting and sometimes confounding results, and have exclusively relied on single-equation estimates of family planning program effectiveness. Economic theories suggest that single-equation estimates may understate program effectiveness when the same unobserved variable affects both the fertility outcome and contraceptive behavior. To eliminate the bias that may result from single-equation estimation, I use a bivariate probit model to estimate the effect of contraceptive acceptance on the individual's probability of giving birth. I employ a rich and unique data set created from Medicaid claims and eligibility records of the State of Maryland. Results from bivariate probit estimation show that contraceptive acceptance plays a much larger role in reducing fertility than single-equation estimates would suggest, due to a significant positive correlation between the unobservable variables that affect both fertility and contraception.

Suggested Citation

  • Jennifer M. Mellor, 1997. "The Effect of Family Planning Programs on the Fertility of Welfare Recipients: Evidence from Medicaid Claims," JCPR Working Papers 9, Northwestern University/University of Chicago Joint Center for Poverty Research.
    • Handle: RePEc:wop:jopovw:9
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    Cited by:

    1. Martha J. Bailey, 2012. "Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 62-97, April.
    2. Thomas DeLeire & Leonard Lopoo & Kosali Simon, 2011. "Medicaid Expansions and Fertility in the United States," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 725-747, May.
    3. Stefan Bauernschuster & Michael Grimm & Cathy M. Hajo, 2023. "The Impact of Margaret Sanger’s Birth Control Clinics on Early 20th Century U.S. Fertility and Mortality," CESifo Working Paper Series 10421, CESifo.
    4. Naci Mocan & Kaj Gittings, 2010. "The Impact of Incentives on Human Behavior: Can We Make it Disappear? The Case of the Death Penalty," NBER Chapters, in: The Economics of Crime: Lessons For and From Latin America, pages 379-418, National Bureau of Economic Research, Inc.
    5. Martha J. Bailey, 2013. "Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 44(1 (Spring), pages 341-409.
    6. Michael J. Camasso, 2004. "Isolating the Family Cap Effect on Fertility Behavior: Evidence From New Jersey's Family Development Program Experiment," Contemporary Economic Policy, Western Economic Association International, vol. 22(4), pages 453-467, October.
    7. Joelle Abramowitz, 2018. "Planning parenthood: the Affordable Care Act young adult provision and pathways to fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 31(4), pages 1097-1123, October.
    8. Frenette, Marc & Picot, Garnett & Sceviour, Roger, 2004. "When do they leave? The dynamics of living in low-income neighbourhoods," Journal of Urban Economics, Elsevier, vol. 56(3), pages 484-504, November.
    9. Julie L. Hotchkiss, 2004. "A Closer Look at the Employment Impact of the Americans with Disabilities Act," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
    10. Frenette, Marc, 2004. "The overqualified Canadian graduate: the role of the academic program in the incidence, persistence, and economic returns to overqualification," Economics of Education Review, Elsevier, vol. 23(1), pages 29-45, February.
    11. Bundervoet, Tom, 2014. "What explains Rwanda's drop in fertility between 2005 and 2010 ?," Policy Research Working Paper Series 6741, The World Bank.
    12. Karen Mulligan, 2015. "Contraception Use, Abortions, and Births: The Effect of Insurance Mandates," Demography, Springer;Population Association of America (PAA), vol. 52(4), pages 1195-1217, August.
    13. Fein, David J., 2001. "Will welfare reform influence marriage and fertility? Early evidence from the ABC demonstration," Evaluation and Program Planning, Elsevier, vol. 24(4), pages 427-444, November.
    14. 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.
    15. Marc Frenette, 2004. "Do the Falling Earnings of Immigrants Apply to Self‐employed Immigrants?," LABOUR, CEIS, vol. 18(2), pages 207-232, June.

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