The proposed research will study the effectiveness of Medicaid-covered family planning services by examining measures of birth rates and health outcomes. Concerns about patterns of welfare dependency among AFDC recipients and the multitude of socioeconomic risks related to teen childbearing strengthen the significance of research of the effects of family planning. In the context of public policy, including current efforts to decrease both welfare rolls and Medicaid costs, the provision of contraceptives has met with growing attention. Recent policy efforts include the provision of the contraceptive implant Norplant to AFDC recipients. The effectiveness of the provision of family planning services will be studied in three essays. First, I will use both state-level and individual-level data to determine how variations in Medicaid family planning expenditures across states and over time have affected birth rates by age, race, marital status, education, and income. This analysis will control for the effects of Medicaid eligibility expansions. Second, I will explore one mechanism behind the effectiveness of family planning in a study of contraceptive implant use. I will use Medicaid claims data to measure the added benefit the implant provides in the way of pregnancy prevention. With these data I will observe marginal increases in the level of pregnancy prevention by comparing contraceptive choices of women before and after the implant was covered by the Medicaid program. Finally, I will examine the existence of indirect costs of the implant by studying the risk-taking behavior of women. Using claims data, I will determine if women who experience declines in their risk of pregnancy then exhibit behavior which would increase the risk of contracting a sexually transmitted disease.
