Association for Public Policy Analysis & Management

This study provides evidence of the impact of health insurance on fertility decision in the context of young adult age 19 to 25. Having health insurance improves access to family planning services and could reduce unwanted pregnancy, which is particularly relevant to the age group studied in this paper. On the other hand, health insurance reduces the price of birth and potentially encourages women who gained coverage to have more children or forgo a potential abortion. The Affordable Care Act young adult mandate has been shown to expand health insurance coverage for the intended age group (Akosa, Moriya and Simon, 2013). Using a differences-in-difference study design, my examination suggests that the mandate reduced the birth rate among the treated group compare to slightly older adults (age 27-29). It also had an effect on prenatal care. I also explore the heterogeneity of responses among race groups and marital status.