, Volume 49, Issue 1, pp 125–149

Utilization of Infertility Treatments: The Effects of Insurance Mandates


DOI: 10.1007/s13524-011-0078-4

Cite this article as:
P. Bitler, M. & Schmidt, L. Demography (2012) 49: 125. doi:10.1007/s13524-011-0078-4


Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health insurance plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this article, we examine whether mandated insurance coverage for infertility treatment affects utilization. We allow utilization effects to differ by age and education, since previous research suggests that older, more-educated women should be more likely to be directly affected by the mandates than younger women and less-educated women, both because they are at higher risk of fertility problems and because they are more likely to have private health insurance, which is subject to the mandate. We find robust evidence that the mandates do have a significant effect on utilization for older, more-educated women that is larger than the effects found for other groups. These effects are largest for the use of ovulation-inducing drugs and artificial insemination.


InfertilityImpaired fecundityHealth insurance mandatesHealth care utilization

Supplementary material

13524_2011_78_MOESM1_ESM.pdf (36 kb)
ESM 1(PDF 35 kb)

Copyright information

© Population Association of America 2011

Authors and Affiliations

  1. 1.University of California-Irvine, RAND Corporation, and NBERIrvineUSA
  2. 2.Department of EconomicsSchapiro Hall, Williams CollegeWilliamstownUSA