Kuroki Masanori
Arkansas Tech University, Arkansas, USA.
Eur J Health Econ. 2025 Jan 3. doi: 10.1007/s10198-024-01741-8.
This paper examines whether the expansion of Medicaid under the Affordable Care Act (ACA), which increases access to contraceptives to low-income childless women and allows them more autonomy to determine the timing of their pregnancies and births, is associated with lower abortion rates during the period 2008-2017. Using state-level data from the Guttmacher Institute and employing a difference-in-differences method, we find that Medicaid expansion is associated with a meaningful reduction in the abortion rate among women ages 18-24, presumably through increased use of contraceptives among low-income young adults. Our estimates imply that Medicaid expansion is associated with a relative decrease in the abortion rate among this age group, approximately 1-2 per 1000 women. By expanding access to contraceptives, Medicaid expansion may be an effective tool for preventing unplanned pregnancies and, consequently, reducing the number of abortions.
本文探讨了《平价医疗法案》（ACA）下医疗补助计划的扩张是否与2008 - 2017年期间较低的堕胎率相关。该法案增加了低收入无子女妇女获得避孕药具的机会，并使她们在决定怀孕和生育时间上拥有更多自主权。利用古特马赫研究所的州级数据并采用双重差分法，我们发现医疗补助计划的扩张与18 - 24岁女性堕胎率的显著降低相关，这大概是由于低收入年轻人对避孕药具的使用增加。我们的估计表明，医疗补助计划的扩张与该年龄组堕胎率的相对下降相关，每1000名妇女中约下降1 - 2例。通过扩大避孕药具的可及性，医疗补助计划的扩张可能是预防意外怀孕进而减少堕胎数量的有效工具。
