Dr. Joanna Venator, Boston College, Assistant Professor, Economics
Title: Reproductive Policy Uncertainty and Defensive Investments in Contraception
Abstract: We investigate the role of the volatile reproductive healthcare policy environment in women's choice of a contraceptive method. We model contraceptive choice as a dynamic discrete choice under uncertainty about future pregnancy, abortion access, and contraceptive method costs. Using de-identified patient records from Planned Parenthood of Wisconsin and Planned Parenthood of Northern New England, we evaluate the impacts of four shocks: Wisconsin's 2015 announcement and then passage of a 20-week abortion ban, Maine and Vermont's 2016 reproductive healthcare expansions, and the 2016 presidential election. We find that women are forward-looking, switching to lower failure methods when they expect abortion access may fall and to longer-lasting methods when they expect costs may rise. Next, we build a formal model to quantify the change in policy expectations that explains behavior after the 2016 election and test a series of policy counterfactuals. We show that the election caused women to expect a 25% lower likelihood of future access to in-state abortion and a 40% lower chance of continued insurance coverage for contraception. We then show that policies which restrict access shift women away from their preferred method in an unconstrained world, creating large welfare losses for all women -- not just those who experience a pregnancy or birth. We estimate that eliminating abortion access and insurance coverage for contraception would reduce welfare by $348 billion for women in their 20s alone. In contrast, providing free abortion access and free contraception would increase welfare by $57 billion for women in their 20s.
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