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Subsidizing contraception: Effects on contraceptive coverage, abortions, and births
1Lund University, Department of Economics, Sweden.
Journal of Health Economics
|February 17, 2026
Summary
The Affordable Care Act
Area of Science:
- Health Economics
- Reproductive Health
- Public Policy
Background:
- Health insurance expansion impacts fertility through contraception access and childbearing costs.
- The Affordable Care Act's Medicaid expansion offers insights into these effects.
Purpose of the Study:
- To analyze the Affordable Care Act's Medicaid expansion effects on contraceptive provision, births, and abortions.
- To distinguish the role of subsidized contraception in fertility outcomes.
Main Methods:
- Employed difference-in-differences models with state-level data.
- Analyzed data on contraceptive provision, births, and abortions.
- Synthesized outcomes to isolate the impact of subsidized contraception.
Main Results:
- Medicaid expansion significantly increased contraceptive provision, especially short-acting hormonal methods.
- Teen birth rates decreased by 5% due to increased parental eligibility.
- Overall birth rates showed no significant change; abortion effects were imprecise but suggested teen reductions.
- Simulations indicated 1%-2% reductions in pregnancy and birth rates attributable to subsidized contraception.
Conclusions:
- Medicaid's contraceptive subsidies modestly reduced pregnancies, abortions, and births.
- Financial barriers to reproductive healthcare are not the primary driver of overall fertility behavior.
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