Subsidized Contraception, Fertility, and Sexual Behavior

Area of Science:

• Health Services Research
• Public Health Policy
• Reproductive Health

Background:

• Recent state-level Medicaid policy changes have broadened eligibility for family planning services.
• These expansions target higher-income women and individuals nearing benefit expiration.

Purpose of the Study:

• To evaluate the impact of expanded Medicaid eligibility on family planning services.
• To quantify the effects on birth rates, particularly among teens and newly eligible women.
• To assess the cost-effectiveness of averted births resulting from these policy changes.

Main Methods:

• Analysis of state-level Medicaid policy changes affecting family planning services.
• Statistical examination of birth rate reductions among different demographic groups (teens, non-teens, newly eligible women).
• Estimation of the cost per averted birth associated with expanded eligibility.

Main Results:

• The income-based policy change led to a 2% reduction in overall non-teen births and over 4% reduction in teen births.
• A significant estimated decline of 9% in births was observed among newly eligible women.
• The observed fertility reduction is linked to increased contraceptive utilization.

Conclusions:

• Expanded Medicaid eligibility for family planning services effectively reduces birth rates, especially among vulnerable populations.
• The policy demonstrates a cost-effective approach to reproductive health, with an estimated $6,800 cost per averted birth.
• Increased access to contraception is a key mechanism driving the observed declines in fertility.