The ACA Medicaid expansions and abortion rates among young adults

Masanori Kuroki ()
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Masanori Kuroki: Arkansas Tech University

The European Journal of Health Economics, 2025, vol. 26, issue 6, No 5, 969-985

Abstract: Abstract This paper examines whether the expansion of Medicaid under the Affordable Care Act (ACA), which increases access to contraceptives to low-income childless women and allows them more autonomy to determine the timing of their pregnancies and births, is associated with lower abortion rates during the period 2008–2017. Using state-level data from the Guttmacher Institute and employing a difference-in-differences method, we find that Medicaid expansion is associated with a meaningful reduction in the abortion rate among women ages 18–24, presumably through increased use of contraceptives among low-income young adults. Our estimates imply that Medicaid expansion is associated with a relative decrease in the abortion rate among this age group, approximately 1–2 per 1000 women. By expanding access to contraceptives, Medicaid expansion may be an effective tool for preventing unplanned pregnancies and, consequently, reducing the number of abortions.

Keywords: Abortion; Health insurance; Contraceptives; Pregnancy (search for similar items in EconPapers)
JEL-codes: I12 I18 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01741-8

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