Medicaid Expansions and Fertility in the United States

Beginning in the mid 1980s and extending through the early to mid 1990s, a substantial number of women and children 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 measure changes in state Medicaid eligibility policy by simulating the fraction of a standard population that would qualify for benefits. From 1985 to 1996, the fraction of women aged 15 to 44 who were eligible for Medicaid coverage for a pregnancy increased on average by 24 percentage points. However, contrary to findings in the extant literature, our results do not indicate that this expansion in coverage had a statistically discernible effect on fertility.