, Volume 48, Issue 2, pp 725–747 | Cite as

Medicaid Expansions and Fertility in the United States

  • Thomas DeLeire
  • Leonard M. Lopoo
  • Kosali I. Simon


Beginning in the mid-1980s and extending through the early to mid-1990s, a substantial number of women and children in the United States gained eligibility for Medicaid through a series of income-based expansions. Using natality data from the National Center for Health Statistics, we estimate fertility responses to these eligibility expansions. We follow Currie and Gruber (2001) and measure changes in state Medicaid-eligibility policy by simulating the fraction of a standard population that would qualify for benefits in different states and different time periods. From 1985 to 1996, the fraction of women aged 15–44 who were eligible for Medicaid coverage for a pregnancy increased more than 20 percentage points. When we use a state and year fixed-effects model with a limited set of covariates, our estimates indicate that fertility increases in response to Medicaid expansions. However, after we include fixed effects for demographic characteristics, the estimated relationship diminishes substantially in size and is no longer statistically significant. We conclude that there is no robust relationship between Medicaid expansions and fertility.


Medicaid Fertility 



We are grateful to Dan Black, Robert Kaestner, Melissa Kearney, Jeffrey Kubik, and seminar participants at Indiana University and RAND for helpful comments. We also thank Jonathan Gruber for sharing the Medicaid eligibility programs used in his previous research as well as Melissa Kearney for sharing her data on family caps, welfare waivers, and TANF implementation.

Supplementary material

13524_2011_31_MOESM1_ESM.doc (46 kb)
Table 10 Estimates for Medicaid eligibility for teens, high school dropouts, and unmarried women, 1989–1997 (DOC 46 kb)
13524_2011_31_MOESM2_ESM.doc (46 kb)
Table 11 Estimates for Medicaid eligibility for teens and high school dropouts, 1989–1997 (DOC 46 kb)
13524_2011_31_MOESM3_ESM.doc (47 kb)
Table 12 Estimates for Medicaid eligibility for the full sample, 1986–1997, first birth only (DOC 47 kb)
13524_2011_31_MOESM4_ESM.doc (46 kb)
Table 13 Estimates for Medicaid eligibility for the full sample, 1986–1997, new weights (DOC 46 kb)
13524_2011_31_MOESM5_ESM.doc (46 kb)
Fig. 2 Proportion eligible for Medicaid: White women (DOC 46 kb)
13524_2011_31_MOESM6_ESM.doc (46 kb)
Fig. 3 Proportion eligible for Medicaid: African American women (DOC 46 kb)


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Copyright information

© Population Association of America 2011

Authors and Affiliations

  • Thomas DeLeire
    • 1
  • Leonard M. Lopoo
    • 2
  • Kosali I. Simon
    • 3
  1. 1.University of Wisconsin–Madison and NBERMadisonUSA
  2. 2.Department of Public Administration, The Maxwell SchoolSyracuse UniversitySyracuseUSA
  3. 3.Indiana University and NBERBloomingtonUSA

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