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The Effect Of State Insurance Mandates On Infant Immunization Rates

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  • Lenisa V. Chang

Abstract

While US infant immunization rates have been increasing in the last 20 years, the cost of fully immunizing a child with all recommended vaccines has almost tripled. This is partly not only due to new additions in the list of recommended vaccines but also due to the use of new, safer, but more expensive technologies in vaccine production and distribution. In recent years, many states have mandated that recommended childhood vaccines be covered by private health insurance companies. Currently, there are 33 states with such a mandate. In this paper, I examine whether the introduction of mandates on private insurers affected immunization rates. Using state and time variation, I find that mandates increased the immunization rate for three vaccines—the diphtheria–tetanus–pertussis, polio, and measles–mumps–rubella vaccines—by about 1.8 percentage points. These results may provide a lower bound for the expected effect of the Affordable Care Act, which mandates coverage of childhood vaccines for all private insurers in the USA. I also find evidence that the mandates shifted a significant portion of vaccinations from publicly funded sources to private ones, with a decline in public health clinic visits and an increase in vaccinations at hospitals and doctor's offices. Copyright © 2015 John Wiley & Sons, Ltd.

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  • Lenisa V. Chang, 2016. "The Effect Of State Insurance Mandates On Infant Immunization Rates," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 372-386, March.
    • Handle: RePEc:wly:hlthec:v:25:y:2016:i:3:p:372-386
    DOI: 10.1002/hec.3153
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    5. Liebman, Eli & Lawler, Emily C. & Dunn, Abe & Ridley, David B., 2023. "Consequences of a shortage and rationing: Evidence from a pediatric vaccine," Journal of Health Economics, Elsevier, vol. 92(C).
    6. Lawler, Emily C., 2017. "Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine," Journal of Health Economics, Elsevier, vol. 52(C), pages 45-62.
    7. Lenisa V. Chang, 2018. "Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1043-1062, July.
    8. Schaller, Jessamyn & Schulkind, Lisa & Shapiro, Teny, 2019. "Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life," Journal of Health Economics, Elsevier, vol. 67(C).
    9. Son, Jinyeong, 2022. "Do mandated health insurance benefits for diabetes save lives?," Journal of Public Economics, Elsevier, vol. 216(C).
    10. Shen, Yichen & Noguchi, Haruko, 2021. "Impacts of anticancer drug parity laws on mortality rates," Social Science & Medicine, Elsevier, vol. 272(C).

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