Working Paper: NBER ID: w17668
Authors: Marianne P. Bitler; Lucie Schmidt
Abstract: Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health insurance plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this paper, we examine whether mandated insurance coverage for infertility treatment affects utilization. We allow utilization effects to differ by age and education, since previous research suggests that older, more educated women should be more likely to be directly affected by the mandates than younger women and less educated women, both because they are at higher risk of fertility problems and because they are more likely to have private health insurance which is subject to the mandate. We find robust evidence that the mandates do have a significant effect on utilization for older, more educated women that is larger than the effects found for other groups. These effects are largest for the use of ovulation-inducing drugs and artificial insemination.
Keywords: infertility treatment; insurance mandates; utilization; health care access
JEL Codes: I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| mandated insurance coverage for infertility treatment (I13) | increased utilization among older, more educated women (I24) |
| living in a state with an infertility insurance mandate (G52) | increased probability of ever seeking medical help for infertility (J13) |
| mandates (D72) | increased use of ovulation-inducing drugs and artificial insemination (J13) |