Association for Public Policy Analysis & Management

Prior studies provide compelling evidence that the introduction of the birth control pill increased educational opportunities for women by helping them avoid unplanned pregnancies. With vast changes in opportunities for women and advances in contraceptive technology, evidence is needed on how access to affordable contraception contributes to socioeconomic outcomes for a more recent generation of women. In this study, we examine the effects of state Medicaid family planning programs on women’s educational attainment.

Methods

Between 1997 and 2010, 21 states implemented waivers allowing low-income women not eligible for comprehensive Medicaid benefits to access contraception at low or no cost. We take advantage of the variation in the presence and timing of waiver implementation to identify the effects of access to affordable contraception on educational attainment. We use data from the 2001-2015 American Community Survey to examine the effects of family planning waivers on a cohort of women born between 1970 and 1990 who were ages 25-40 from 2001-2015.

We assign exposure to a waiver based on a woman’s state of residence at the time of the survey and her birth year, and examine timing of exposure using two mutually exclusive indicators: (1) extended exposure (exposure at or before age 19) and (2) limited exposure (exposure after age 19, but before age 25). We use state, survey year, and birth year fixed effects to identify the effects of variation in exposure to family planning waivers on educational attainment, and control for age, race/ethnicity, and citizenship. We also examine effects on parenthood and age at first birth to assess the mechanism for socioeconomic benefits, and stratify our sample by race/ethnicity.

Findings

Among all women, we find that extended exposure to a family planning waiver increased the probability of graduating from high school by 1.4 percentage points (p=.071). When stratified by race/ethnicity, exposure to a waiver had no effect on educational attainment among white women, but limited exposure to a waiver increased the probability of attending college by 1.0 percentage point (p=.044) among black women. We also find that extended exposure to a waiver increased the probability of completing high school (3.6 percentage points, p=.024), attending college (3.0 percentage points, p=.003), and completing college (2.5 percentage points, p=.001) among Hispanic women. In addition, we find that extended exposure reduced single parenthood among all women, and increased age at first birth among black and Hispanic women. Only the results among Hispanic women were robust to the inclusion of state-specific linear birth-year trends, with extended exposure increasing the probability of college attendance by 0.9 percentage points (p=.012) and college completion by 1.3 percentage points (p=.029). Additional analysis suggests that these results are largely driven by California’s family planning waiver.

Conclusions

This analysis suggests that expanding access to affordable contraception during the teen years had benefits for women’s educational attainment, particularly among Hispanic women in California. As policy debates related to women’s reproductive health continue, these findings provide some evidence of the benefits of affordable access to contraception, but additional research is needed.