Expanded Access to Affordable Contraception and Women’s Educational Attainment

Tuesday, June 12, 2018: 8:20 AM
Hickory - Garden Level (Emory Conference Center Hotel)

Presenter: Stacey McMorrow

Co-Authors: Emily Johnston; Michael Karpman; Jason Gates; Genevieve Kenney

Discussant: Andrew Goodman-Bacon

Prior studies provide compelling evidence of the long-term socioeconomic benefits associated with the introduction of the birth control pill in the 1960s. With vast changes in economic opportunities for women and a proliferation of more effective forms of contraception, evidence is needed on how access to affordable contraception contributes to the long-term socioeconomic outcomes of a more recent generation of women. In this study, we examine the effects of state Medicaid family planning waivers on educational attainment among women.

Study Design

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 access to affordable contraception induced by the implementation of these waivers to identify the effects of affordable contraception on parenthood, age at first birth, and educational attainment. We use data from the 1995-2015 Current Population Survey (CPS) to examine the effects of exposure to family planning waivers on a broad cohort of women ages 25-40 born between 1970 and 1990.

We assign women exposure to a waiver at ages 15-24 based on their state of residence at the time of the survey and their birth year. We use state, survey year, and birth year fixed effects to identify the effects of variation in exposure to family planning waivers on our outcomes of interest. Some models also include state-specific linear birth year trends, which help account for unobserved state-specific changes that may be correlated with waiver implementation and educational opportunities for women across birth cohorts. Finally, we control for age group, race/ethnicity, and citizenship.

Principal Findings

We find that any exposure to a waiver at ages 15-24 increased the probability of attending college and completing college, and reduced the number of children among parents. We further examine the timing of exposure and find that extended exposure to a waiver (e.g., exposure starting before age 20) increased the probability of completing high school by 1.5 percentage points, attending college by 1.9 percentage points and completing college by 2.5 percentage points. More limited exposure (e.g., exposure starting after age 19) increased the probability of college attendance and completion by 1.4 and 1.2 percentage points, respectively. Extended exposure also reduced the probability of being a single parent, and limited exposure increased age at first birth. Our results by race/ethnicity suggest stronger effects on high school completion among Hispanic women, college attendance among black women, and college completion among white and Hispanic women.


This analysis suggests that expanding women’s access to affordable contraception increases their ability to attend and graduate from college. Our findings of reduced childbearing and increased age at first birth highlight that improvements in women’s educational attainment may be attributable to their increased ability to prevent and plan pregnancies. These findings have important implications as policymakers continue to debate the future of access to affordable contraception.