Apostolova-Mihaylova, Maria and Yelowitz, Aaron (2015): Health Insurance, Fertility, and the Wantedness of Pregnancies: Evidence from Massachusetts.
Preview |
PDF
MPRA_paper_61237.pdf Download (346kB) | Preview |
Abstract
Health insurance reform in Massachusetts lowered the financial cost of both pregnancy (by increased coverage of pregnancy-related medical events) and pregnancy prevention (by increasing access to reliable contraception and family planning). We examine fertility responses for women of childbearing age in Massachusetts and, on net, find no effect from increasing health insurance coverage. This finding, however, masks substantial heterogeneity. For married women aged 20 to 34 – who have high latent fertility and for whom pregnancies are typically wanted – fertility increased by approximately 1 percent. For unmarried women in the same age range – for whom pregnancies are typically unwanted – fertility declined by 9 percent. Fertility rates changed very little for other groups, in part because of low latent fertility or minimal gains in insurance coverage. Pregnancy wantedness increased in the aggregate through a combination of increasing wanted births and decreasing unwanted births.
Item Type: | MPRA Paper |
---|---|
Original Title: | Health Insurance, Fertility, and the Wantedness of Pregnancies: Evidence from Massachusetts |
Language: | English |
Keywords: | Health Insurance, Fertility, Moral Hazard, Pregnancy Wantedness |
Subjects: | I - Health, Education, and Welfare > I1 - Health I - Health, Education, and Welfare > I1 - Health > I13 - Health Insurance, Public and Private I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health J - Labor and Demographic Economics > J1 - Demographic Economics J - Labor and Demographic Economics > J1 - Demographic Economics > J13 - Fertility ; Family Planning ; Child Care ; Children ; Youth |
Item ID: | 61237 |
Depositing User: | Aaron Yelowitz |
Date Deposited: | 12 Jan 2015 05:17 |
Last Modified: | 28 Sep 2019 10:50 |
References: | Agüero, J.M., Marks, M.S., 2011. “Motherhood and Female Labor Supply in the Developing World: Evidence from Infertility Shocks,” Journal of Human Resources, 46 (4), 800-826. Aizer, A., Currie, J., Moretti, E., 2007. “Does Managed Care Hurt Health? Evidence from Medicaid Mothers,” The Review of Economics and Statistics, 89 (3), 385-399. Ananat, E.O, Gruber, J., Levine, P.B., 2007. “Abortion Legalization and Life-Cycle Fertility,” Journal of Human Resources, 42 (2), 375-397. Bernstein, A.B., Cohen, R.A., Brett, K.M., Bush, M.A., 2008. “Marital Status is Associated With Health Insurance Coverage for Working-age Women at all Income Levels, 2007,” NCHS Data Brief, No. 11. Hyattsville, MD: National Center for Health Statistics. Buckles, K.S., Munnich, E.L., 2012. “Birth Spacing and Sibling Outcomes,” Journal of Human Resources, 47 (3), 613-642. Chandra, A., Gruber, J., McKnight, R., 2011. “The Importance of the Individual Mandate – Evidence From Massachusetts,” New England Journal of Medicine, 364 (4), 293-295. Chakrabarti, R., Roy, J., 2011. “Do Charter Schools Crowd Out Private School Enrollment? Evidence from Michigan,” Working paper, Federal Reserve Bank of New York, Accessed January 9, 2015 from: http://www.newyorkfed.org/research/staff_reports/sr472.pdf Courtemanche, C., Zapata, D., 2014. “Does Universal Coverage Improve Health? The Massachusetts Experience,” Journal of Policy Analysis and Management, 33 (1), 36-69. Currie, J., Gruber, J., 2001. “Public Health Insurance and Medical Treatment: The Equalizing Impact of the Medicaid Expansions,” Journal of Public Economics, 82 (1), 63-89. DeLeire, T., Lopoo, L., Simon, K., 2011. “Medicaid Expansions and Fertility in the United States,” Demography, 48 (2), 725-747. Dennis, A., Córdova, D., Blanchard, K., Wahlin, B., 2009. “Low-Income Women’s Access to Contraception After Massachusetts Health Care Reform,” IBIS Reproductive Health and MDPH Family Planning Program. Dennis, A., Clark, J., Córdova, D., McIntosh, J., Edlund, K., Wahlin, B., Blanchard, K., 2012. “Access to Contraception after Health Care Reform in Massachusetts: A Mixed-Methods Study Investigating Benefits and Barriers,” Contraception, 85 (2), 166-172. Department of the Treasury, Department of Labor, Department of Health and Human Services (2013). “Rules and Regulations,” Federal Register, Vol. 78, No. 127, Tuesday, July 2, 2013. Dickert-Conlin, S., Chandra, A., 1999. “Taxes and the Timing of Births,” Journal of Political Economy 107 (1), 161-177. Donohue, J., Levitt, S., 2001. “The Impact of Legalized Abortion on Crime,” Quarterly Journal of Economics, 116 (2), 379-420. Feldstein, M. (2013). “Obamacare’s Fatal Flaw,” Accessed January 9, 2015 from: http://www.project-syndicate.org/commentary/martin-feldstein-on-how-america-s-health-care-reform-could-unravel. Finer, B., Kost, K., 2011. “Unintended Pregnancy Rates at the State Level.” Perspectives on Sexual and Reproductive Health, 43 (2), 78-87. Gans, J.S., Leigh, A., 2009. “Born on the First of July: An (un)natural Experiment in Birth Timing,” Journal of Public Economics, 93 (1), 246–263. Gelbach, J., 2004. “Migration, the Life Cycle and State Benefits: How Low is the Bottom?” Journal of Political Economy, 112 (5), 1091-1130. Gold, R., 2009. Family Planning Centers meet Health Care Reform: Lessons from Massachusetts. Guttmacher Policy Review, 12 (3). Greene, J., 2013. “ACA Contraception Mandate Spurs Litigation Onslaught,” The National Law Journal. Accessed January 9, 2015 from: http://www.law.com/jsp/nlj/PubArticleNLJ.jsp?id=1202626192894&slreturn=20131019224630 Griswold, A., 2014. “How Many People Could the Hobby Lobby Ruling Affect?” Slate, Accessed from http://www.slate.com/blogs/moneybox/2014/06/30/hobby_lobby_supreme_court_ruling_how_many_people_work_at_closely_held_corporations.html Guttmacher Institute, 2015. “State Policies in Brief: An Overview of Abortion Laws,” Accessed from http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf Hackmann, M., Kolstad, J. , Kowalski, A., 2012. “Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform,” American Economic Review, 102 (3), 498-501. Joyce, T., Kaestner, R., 1996. “The Effect of Expansions in Medicaid Income Eligibility on Abortion,” Demography, 33 (2), 181-192. Joyce, T., Kaestner, R., and Kwan, F., 1998. “Is Medicaid Pronatalist? The Effect of Eligibility Expansions on Abortions and Births,” Family Planning Perspectives, 108-127. Kearney, M., Levine, P., 2009. “Subsidized Contraception, Fertility, and Sexual Behavior,” The Review of Economics and Statistics, 91 (1), 137-151. Kolstad, J., Kowalski, A., 2012a. “The Impact of Health Care Reform on Hospital and Preventive Care: Evidence from Massachusetts,” Journal of Public Economics, 96 (11), 909-929. Kolstad, J., Kowalski, A., 2012b. “Mandate-Based Health Reform and the Labor Market: Evidence from the Massachusetts Reform,” Working Paper No. 17933. National Bureau of Economic Research. LaLumia, S., Sallee, J.M., Turner, N., 2013. “New Evidence of Taxes and Timing of Birth,” Working Paper No. 19283. National Bureau of Economic Research. Leibowitz, A., 1990. “The Response of Births to Changes in Health Care Costs,” Journal of Human Resources, 25 (4), 697-711. Long, S., 2008. “On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year.” Health Affairs, 27 (4), 270-284. Long, S., Stockley, K., Yemane, A., 2009. “Another Look at the Impacts of Health Reform in Massachusetts: Evidence using New Data and a Stronger Model.” American Economic Review, 99 (2), 508-511. Marton, J., Yelowitz, A., 2014. “Health Insurance Generosity and Conditional Coverage: Evidence from Medicaid Managed Care in Kentucky,” Forthcoming, Southern Economic Journal. Marton, J., Yelowitz, A., Talbert, J., 2014. “A Tale of Two Cities? The Heterogeneous Impact of Medicaid Managed Care in Kentucky.” Journal of Health Economics, 36 (1), 47-68. Miller, S., 2012a. “The Effect of Insurance on Emergency Room Visits: An Analysis of the 2006 Massachusetts Health Reform,” Journal of Public Economics, 96 (11), 893-908. Miller, S., 2012b. “The Impact of the Massachusetts Health Care Reform on Health Care Use Among Children.” American Economic Review, 102 (3), 502-07. National Committee for a Human Life Amendment, 2008. “The Hyde Amendment”, Accessed on 11/16/2013 from: http://nchla.org/issues.asp?ID=1. National Women’s Law Center. “Women and the Health Care Law in the United States: Fact Sheet,” Accessed November 19, 2013 from: http://www.nwlc.org/sites/default/files/pdfs/us_healthstateprofiles.pdf. Niedzwiecki, M., 2013. “The Effect of Health Insurance Coverage on Hospital Care Utilization and Health: Evidence from a Natural Experiment in Massachusetts”, working paper. Neugart, M., Ohlsson, H., 2013. “Economic Incentives and the Timing of Births: Evidence from the German Parental Benefit Reform of 2007,” Journal of Population Economics, 26 (1), 87-108. Planned Parenthood. “Comparing Effectiveness of Birth Control Methods,” Accessed November 19, 2013 from: http://www.plannedparenthood.org/health-topics/birth-control/birth-control-effectiveness-chart-22710.htm Pop-Eleches, C., 2010. “The Supply of Birth Control Methods, Education, and Fertility: Evidence from Romania,” Journal of Human Resources, 45 (4), 971-997. Schulkind, L., Shapiro, T.M., 2014. “What a Difference a Day Makes: Quantifying the Effects of Birth Timing Manipulation on Infant Health,” Journal of Health Economics, 33 (1), 139-158. Sommers, B., Kronick, R., Finegold, K., Po, R., Schwartz, K., Glied, S., 2012. “Understanding Participation Rates in Medicaid: Implications for the Affordable Care Act,” ASPE Issue Brief, Department of Health & Human Services. Swartz, K., 1986. “Interpreting the Estimates from Four National Surveys of the Number of People without Health Insurance,” Journal of Economic and Social Measurement, 14 (3), 233-42. The Henry J. Kaiser Family Foundation, 2012. “Focus on Health Reform,” Accessed on 11/16/2013 from: http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8311.pdf Wheaton, S., 2013. “Court Rules Contraception Mandate Infringes on Religious Freedom”, The New York Times, Accessed November 17, 2013 from: http://www.nytimes.com/2013/11/02/us/court-rules-contraception-mandate-infringes-on-religious-freedom.html?ref=contraception&_r=0 U.S. Agency for Healthcare Research and Quality. “HCUPnet, Healthcare Cost and Utilization Project. Rockville, MD: AHRQ,” Accessed November 16, 2013 from: http://transform.childbirthconnection.org/resources/datacenter/chargeschart/. U.S. Centers for Medicare and Medicaid Services. “Can I Buy a Catastrophic Plan?,” Accessed November 19, 2013 from: https://www.healthcare.gov/can-i-buy-a-catastrophic-plan/. U.S. Census Bureau, 2007. “Income, Poverty, and Health Insurance Coverage in the United States: 2006”, accessed from http://www.census.gov/prod/2007pubs/p60-233.pdf U.S. Census Bureau, 2010. “American Community Survey Questions and Answers”, accessed from http://www.census.gov/acs/www/Downloads/language_brochures/ACSQandA_ENG10.pdf U.S. Department of Health and Human Services, Health Resources and Services Administration. “Women’s Preventive Services Guidelines,” Accessed November 19, 2013 from: Yelowitz, A., 1994. “Is Health Care Coverage a Pro-Natal Policy?” Unpublished Ph.D. dissertation. Yelowitz, A., 1998. “Will Extending Medicaid to Two-Parent Families Encourage Marriage?” Journal of Human Resources, 33 (4), 833-865. Yelowitz, A., Cannon, M., 2010. “The Massachusetts Health Plan: Much Pain, Little Gain.” Cato Policy Analysis Paper No. 657. Zavodny, M., Bitler, M., 2010. “The Effect of Medicaid Eligibility Expansions on Fertility,” Social Science & Medicine, 71 (5), 918-924. |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/61237 |