Public policy - teen fertility links

Teen pregnancy is widely acknowledged as a serious problem in the United States and finding ways to prevent teen pregnancy is an important public policy goal. One approach that is commonly suggested is to improve access to family planning services. Some states have been experimenting with a policy of precisely this nature under the auspices of their Medicaid programs. These states have recently been granted waivers from the federal government allowing them to extend the provision of Medicaid family planning services to more women. Those waivers that have been granted include policies to expand income eligibility to up to 200 percent of the poverty threshold and to extend the right to family planning services for up to 5 years post-partum.  The research will evaluate the role that family planning services may play in reducing teen pregnancies and births by estimating the impact of these Medicaid family planning waivers.  

The study employed an empirical strategy specifically targeted at identifying a causal connection between the additional services provided and fertility outcomes. The study used several sources of data in our analysis, including Vital Statistics Natality data, abortion data available from the Centers for Disease Control and Prevention and from the Alan Guttmacher Institute, and data on sexual behavior and contraceptive use from the National Survey of Family Growth.  The analysis also employed quasi-experimental techniques , examining birth outcomes as well as its antecedents (sexual activity, contraception, pregnancy, and abortion).  The researchers took advantage of the geographic variation over time in the introduction of the waivers, treating those locations in which no policy change took place as a pseudo-control group to help gauge the causal impact of the policy in those locations that offered additional family planning services.  The analysis also compared outcomes across states and across years for those more likely to be eligible for the waiver programs and those less likely to be eligible due to their higher income.  Finally, analysis was conducted for all teens and for teens separated by race/ethnicity to determine whether a differential impact across groups exists.

Prof. Kearney and Phillip B. Levine of Wellesley College wrote up a brief for the Brookings Institution that summarizes the technical academic paper.

For further information, contact Melissa Kearney.