Featured on CBS News, CCPR Director Martha Bailey’s new working paper uses a randomized controlled trial to quantify how funding for reproductive health affects pregnancies and abortions in the US.
Read the article featured by CBS News at https://www.cbsnews.com/news/reproductive-health-trump-administration-hhs-cuts/
In this new working paper (https://www.nber.org/papers/w34400), Director Bailey finds that subsidizing reproductive health services for low-income Americans significantly reduces unintended pregnancies and abortions within two years. The randomized controlled trial (RCT), Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES), comprising more than 3,000 women, tested the impact of vouchers to make contraception highly discounted or free. Participants who received vouchers were 25 percentage points (69%) more likely to purchase contraception, spent $331 (286%) more on contraceptives, and expected contraceptive failures fell by 24 percentage points (37%). The vouchers also impacted the choice of contraception method, showing a sharp increase (12 percentage points; 217%) in the use of long-acting reversible contraceptive methods, with effects persisting at two years, suggesting that contraceptive costs meaningfully constrain method choice in the long run.
Using linked survey and administrative health data, the study also found that by 26 months, receiving the voucher reduced the cumulative incidence of pregnancies by 16% and abortions by 12%, implying that many of the pregnancies prevented by changes in contraception were unintended. Although births also declined, that effect was not statistically significant.
These results contrast with earlier research findings that the cost of contraception is a minor barrier or has a negligible impact on the choice of contraception method among teens or low-income populations. By employing survey and administrative data, this RCT improves upon earlier research, offering rigorous causal evidence that lowering the out-of-pocket costs for contraception is an effective and scalable strategy to reduce unintended pregnancies.
