IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/12820.html
   My bibliography  Save this paper

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

Author

Listed:
  • 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
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w12820.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Schmidt, Lucie, 2007. "Effects of infertility insurance mandates on fertility," Journal of Health Economics, Elsevier, vol. 26(3), pages 431-446, May.
    2. 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.
    3. Andersen, Martin, 2015. "Heterogeneity and the effect of mental health parity mandates on the labor market," Journal of Health Economics, Elsevier, vol. 43(C), pages 74-84.
    4. Li, Xiaoxue & Ye, Jinqi, 2017. "The spillover effects of health insurance benefit mandates on public insurance coverage: Evidence from veterans," Journal of Health Economics, Elsevier, vol. 55(C), pages 45-60.
    5. James M. Poterba, 1996. "Government Intervention in the Markets for Education and Health Care: How and Why?," NBER Chapters, in: Individual and Social Responsibility: Child Care, Education, Medical Care, and Long-Term Care in America, pages 277-308, National Bureau of Economic Research, Inc.
    6. 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.
    7. Thomas C. Buchmueller & John DiNardo & Robert G. Valletta, 2011. "The Effect of an Employer Health Insurance Mandate on Health Insurance Coverage and the Demand for Labor: Evidence from Hawaii," American Economic Journal: Economic Policy, American Economic Association, vol. 3(4), pages 25-51, November.
    8. Lucie Schmidt, 2005. "Infertility Insurance Mandates and Fertility," American Economic Review, American Economic Association, vol. 95(2), pages 204-208, May.
    9. Baum, Charles II, 2003. "The effect of state maternity leave legislation and the 1993 Family and Medical Leave Act on employment and wages," Labour Economics, Elsevier, vol. 10(5), pages 573-596, October.
    10. Jonathan Gruber, 1992. "The Efficiency of a Group-Specific Mandated Benefit: Evidence From Health Insurance Benefits for Maternity," NBER Working Papers 4157, National Bureau of Economic Research, Inc.
    11. Uribe, Ana Maria Tribin & Vargas, Carmiña O. & Bustamante, Natalia Ramírez, 2019. "Unintended consequences of maternity leave legislation: The case of Colombia," World Development, Elsevier, vol. 122(C), pages 218-232.
    12. repec:eee:labchp:v:3:y:1999:i:pc:p:3417-3528 is not listed on IDEAS
    13. Aparna Mathur, 2010. "Health insurance and job creation by the self-employed," Small Business Economics, Springer, vol. 35(3), pages 299-317, October.
    14. Ye, Jinqi & Peng, Bin, 2024. "The effects of state and federal mental health parity laws on working time in the US," Economic Analysis and Policy, Elsevier, vol. 82(C), pages 685-700.
    15. Christine Jolls, 2007. "Employment Law and the Labor Market," NBER Working Papers 13230, National Bureau of Economic Research, Inc.
    16. Maclean, J. Catherine & Pichler, Stefan & Ziebarth, Nicolas R., 2020. "Mandated Sick Pay: Coverage, Utilization, and Welfare Effects," IZA Discussion Papers 13132, Institute of Labor Economics (IZA).
    17. E. Mark Curtis & Barry T. Hirsch & Mary C. Schroeder, 2016. "Evaluating Workplace Mandates with Flows Versus Stocks: An Application to California Paid Family Leave," Southern Economic Journal, John Wiley & Sons, vol. 83(2), pages 501-526, October.
    18. Bhattacharya, Jay & Bundorf, M. Kate, 2009. "The incidence of the healthcare costs of obesity," Journal of Health Economics, Elsevier, vol. 28(3), pages 649-658, May.
    19. David H. Autor & John J. Donohue & Stewart J. Schwab, 2006. "The Costs of Wrongful-Discharge Laws," The Review of Economics and Statistics, MIT Press, vol. 88(2), pages 211-231, May.
    20. 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.
    21. 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.

    More about this item

    JEL classification:

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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:12820. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.