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The Effects Of Insurance Mandates On Choices And Outcomes In Infertility Treatment Markets

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  • Barton H. Hamilton
  • Brian McManus

Abstract

For the 10% to 15% of American married couples who experience reproductive problems, in vitro fertilization (IVF) is the leading technologically advanced treatment procedure. However, IVF's expense may prevent many couples from receiving treatment, and those who are treated may take an overly aggressive approach to reduce the probability of failure. Aggressive treatment, which occurs through an increase in the number of embryos transferred during IVF, can lead to medically dangerous multiple births. We evaluated the principle policy proposal—insurance mandates—for improving IVF access and outcomes. We used data from US markets during 1995–2003 to show that broad insurance mandates for IVF result in not only large increases in treatment access but also significantly less aggressive treatment. More limited insurance mandates, which may apply to a subset of insurers or provide weaker guidelines for insurer behavior, generally have little effect on IVF markets. Copyright © 2011 John Wiley & Sons, Ltd.

Suggested Citation

  • Barton H. Hamilton & Brian McManus, 2012. "The Effects Of Insurance Mandates On Choices And Outcomes In Infertility Treatment Markets," Health Economics, John Wiley & Sons, Ltd., vol. 21(8), pages 994-1016, August.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:8:p:994-1016
    DOI: 10.1002/hec.1776
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    1. David C. Schmittlein & Donald G. Morrison, 2003. "A Live Baby or Your Money Back: The Marketing of In Vitro Fertilization Procedures," Management Science, INFORMS, vol. 49(12), pages 1617-1635, December.
    2. M. Kate Bundorf & Melinda Henne & Laurence Baker, 2007. "Mandated Health Insurance Benefits and the Utilization and Outcomes of Infertility Treatments," NBER Working Papers 12820, National Bureau of Economic Research, Inc.
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    6. Schmidt, Lucie, 2007. "Effects of infertility insurance mandates on fertility," Journal of Health Economics, Elsevier, vol. 26(3), pages 431-446, May.
    7. Marianne Bitler & Lucie Schmidt, 2006. "Health disparities and infertility: impacts of state-level insurance mandates," Department of Economics Working Papers 2006-04, Department of Economics, Williams College, revised Nov 2006.
    8. Gruber, Jonathan, 1994. "State-mandated benefits and employer-provided health insurance," Journal of Public Economics, Elsevier, vol. 55(3), pages 433-464, November.
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    Cited by:

    1. Naomi Gershoni & Corinne Low, 2021. "Older Yet Fairer: How Extended Reproductive Time Horizons Reshaped Marriage Patterns in Israel," American Economic Journal: Applied Economics, American Economic Association, vol. 13(1), pages 198-234, January.
    2. Matilde Machado & Anna Sanz-de-Galdeano, 2015. "Coverage of infertility treatment and fertility outcomes," SERIEs: Journal of the Spanish Economic Association, Springer;Spanish Economic Association, vol. 6(4), pages 407-439, November.
    3. Karen Mulligan, 2015. "Contraception Use, Abortions, and Births: The Effect of Insurance Mandates," Demography, Springer;Population Association of America (PAA), vol. 52(4), pages 1195-1217, August.
    4. Bingxiao Wu, 2019. "Information presentation and consumer choice: Evidence from Assisted Reproductive Technology (ART) Success Rate Reports," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 868-883, July.
    5. Gershoni, Naomi & Low, Corinne, 2021. "The power of time: The impact of free IVF on Women’s human capital investments," European Economic Review, Elsevier, vol. 133(C).
    6. Joelle Abramowitz, 2014. "Turning back the ticking clock: the effect of increased affordability of assisted reproductive technology on women’s marriage timing," Journal of Population Economics, Springer;European Society for Population Economics, vol. 27(2), pages 603-633, April.
    7. Fabio I. Martinenghi & Xian Zhang & Luk Rombauts & Georgina M. Chambers, 2024. "Conceiving Naturally After IVF: the effect of assisted reproduction on obstetric interventions and child health at birth," Papers 2405.00234, arXiv.org, revised Sep 2024.
    8. Joelle Abramowitz, 2017. "Assisted Reproductive Technology and Women’s Timing of Marriage and Childbearing," Journal of Family and Economic Issues, Springer, vol. 38(1), pages 100-117, March.
    9. Sarah Kroeger & Giulia La Mattina, 2017. "Assisted reproductive technology and women’s choice to pursue professional careers," Journal of Population Economics, Springer;European Society for Population Economics, vol. 30(3), pages 723-769, July.
    10. Sarah Kroeger & Giulia La Mattina, 2015. "Assisted Reproductive Technology and Women�s Choice to Pursue Professional Careers," Working Papers 0115, University of South Florida, Department of Economics.

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