CONTEXT: Income thresholds for Medicaid eligibility for pregnant women were raised in two phases between 1987 and 1991. During roughly the same period, the U.S. fertility rate rose and the abortion rate declined; changes were particularly marked among young women, raising the possibility that fertility increases were related to Medicaid expansions. METHODS: Pooled time-series cross-section regressions were used to examine the effects of the Medicaid eligibility expansions in 15 states on rates of abortions and births among unmarried women aged 19-27 with 12 or fewer years of schooling. Abortion data came from the National Center for Health Statistics or state health departments and were aggregated by women's age, race, marital status and schooling; data on births were from national natality tapes. RESULTS: The Medicaid expansions were associated with a 5% increase in the birthrate among white women, but did not influence the rate among black women. Overall, no effect on the abortion rate was evident, but in analyses restricted to a subsample of eight states with the most complete abortion data, the rate among white women showed a significant decline after the second phase of expansions. CONCLUSIONS: Subsidized health care for low-income pregnant women in these 15 states may have encouraged white women to have more children than they would have without coverage.
CONTEXT: Income thresholds for Medicaid eligibility for pregnant women were raised in two phases between 1987 and 1991. During roughly the same period, the U.S. fertility rate rose and the abortion rate declined; changes were particularly marked among young women, raising the possibility that fertility increases were related to Medicaid expansions. METHODS: Pooled time-series cross-section regressions were used to examine the effects of the Medicaid eligibility expansions in 15 states on rates of abortions and births among unmarried women aged 19-27 with 12 or fewer years of schooling. Abortion data came from the National Center for Health Statistics or state health departments and were aggregated by women's age, race, marital status and schooling; data on births were from national natality tapes. RESULTS: The Medicaid expansions were associated with a 5% increase in the birthrate among white women, but did not influence the rate among black women. Overall, no effect on the abortion rate was evident, but in analyses restricted to a subsample of eight states with the most complete abortion data, the rate among white women showed a significant decline after the second phase of expansions. CONCLUSIONS: Subsidized health care for low-income pregnant women in these 15 states may have encouraged white women to have more children than they would have without coverage.
Entities:
Keywords:
Abortion, Induced; Americas; Birth Rate; Cross Sectional Analysis; Delivery Of Health Care; Demographic Factors; Developed Countries; Economic Factors; Family Planning; Fertility; Fertility Control, Postconception; Fertility Measurements; Fertility Rate; Financial Activities; Financing, Government; Government Sponsored Programs; Health; Health Services; Literature Review; Marital Status; National Health Services; North America; Northern America; Nuptiality; Organization And Administration; Population; Population Dynamics; Programs; Research Methodology; Social Welfare; United States; Unmarried--women