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Mandated Health Insurance Benefits and the Utilization and Outcomes of Infertility Treatments

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  • M. Kate Bundorf
  • Melinda Henne
  • Laurence Baker

Abstract

During the last two decades, the treatment of infertility has improved dramatically. These treatments, however, are expensive and rarely covered by insurance, leading many states to adopt regulations mandating that health insurers cover them. In this paper, we explore the effects of benefit mandates on the utilization and outcomes of infertility treatments. We find that use of infertility treatments is significantly greater in states adopting comprehensive versions of these mandates. While greater utilization had little impact on the number of deliveries, mandated coverage was associated with a relatively large increase in the probability of a multiple birth. For relatively low fertility patients who responded to the expanded insurance coverage, treatment was often unsuccessful and did not result in a live birth. For relatively high fertility patients, in contrast, treatment often led to a multiple, rather than a singleton, birth. We also find evidence that the beneficial effects on the intensive treatment margin that have been proposed in other studies are relatively small. We conclude that, while benefit mandates potentially solve a problem of adverse selection in this market, these benefits must be weighed against the costs of the significant moral hazard in utilization they induce.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:12820
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    References listed on IDEAS

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    1. Gruber, J., 1992. "State Mandated Benefits and Employer Provided Health Insurance," Working papers 92-18, Massachusetts Institute of Technology (MIT), Department of Economics.
    2. Lucie Schmidt, 2005. "Infertility Insurance Mandates and Fertility," American Economic Review, American Economic Association, vol. 95(2), pages 204-208, May.
    3. George J. Stigler, 1971. "The Theory of Economic Regulation," Bell Journal of Economics, The RAND Corporation, vol. 2(1), pages 3-21, Spring.
    4. Marianne Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandates," PPIC Working Papers 2005.06, Public Policy Institute of California.
    5. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    6. Jensen, Gail A & Gabel, Jon R, 1992. "State Mandated Benefits and the Small Firm's Decision to Offer Insurance," Journal of Regulatory Economics, Springer, vol. 4(4), pages 379-404, December.
    7. Marianne Bitler, 2005. "Effects of Increased Access to Infertility Treatment on Infant and Child Health Outcomes: Evidence from Health Insurance Mandates," PPIC Working Papers 2005.06, Public Policy Institute of California.
    8. Michael Rothschild & Joseph Stiglitz, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 90(4), pages 629-649.
    9. Robert Kaestner & Kosali Ilayperuma Simon, 2002. "Labor Market Consequences of State Health Insurance Regulation," ILR Review, Cornell University, ILR School, vol. 56(1), pages 136-159, October.
    10. Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-641, June.
    11. Summers, Lawrence H, 1989. "Some Simple Economics of Mandated Benefits," American Economic Review, American Economic Association, vol. 79(2), pages 177-183, May.
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    Citations

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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. Thomas DeLeire & Leonard Lopoo & Kosali Simon, 2011. "Medicaid Expansions and Fertility in the United States," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 725-747, May.
    4. Ohinata, A., 2011. "Did the US Infertility Health Insurance Mandates Affect the Timing of First Birth?," Discussion Paper 2011-102, Tilburg University, Center for Economic Research.
    5. Machado, Matilde P. & Sanz-de-Galdeano, Anna, 2011. "Coverage of Infertility Treatment and Fertility Outcomes: Do Women Catch Up?," IZA Discussion Papers 5783, Institute of Labor Economics (IZA).
    6. Inna Cintina & Bingxiao Wu, 2019. "How Do State Infertility Insurance Mandates Affect Divorce?," Contemporary Economic Policy, Western Economic Association International, vol. 37(3), pages 560-570, July.
    7. Joanna N. Lahey, 2012. "The efficiency of a group‐specific mandated benefit revisited: The effect of infertility mandates," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 31(1), pages 63-92, December.
    8. Ohinata, A., 2011. "Did the US Infertility Health Insurance Mandates Affect the Timing of First Birth?," Other publications TiSEM dd844a22-78ab-4f48-b1a0-9, Tilburg University, School of Economics and Management.
    9. Kasey S. Buckles, 2013. "Infertility Insurance Mandates And Multiple Births," Health Economics, John Wiley & Sons, Ltd., vol. 22(7), pages 775-789, July.
    10. Marianne Bitler & Lucie Schmidt, 2012. "Utilization of Infertility Treatments: The Effects of Insurance Mandates," Demography, Springer;Population Association of America (PAA), vol. 49(1), pages 125-149, February.
    11. 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.
    12. Bundorf, M. Kate & Chun, Natalie & Goda, Gopi Shah & Kessler, Daniel P., 2009. "Do markets respond to quality information? The case of fertility clinics," Journal of Health Economics, Elsevier, vol. 28(3), pages 718-727, May.
    13. 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.
    14. Son, Jinyeong, 2022. "Do mandated health insurance benefits for diabetes save lives?," Journal of Public Economics, Elsevier, vol. 216(C).
    15. 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.

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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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