Flint switched its public water source in April 2014, increasing exposure to lead and other contaminants. We compare the change in the fertility rate and in health at birth in Flint before and after the water switch to the changes in other cities in Michigan. We find that Flint fertility rates decreased by 12 % and that overall health at birth decreased. This effect on health at birth is a function of two countervailing mechanisms: (1) negative selection of less healthy embryos and fetuses not surviving (raising the average health of survivors), and (2) those who survived being scarred (decreasing average health). We untangle this to find a net of selection scarring effect of 5.4 % decrease in birth weight. Because of long-term effects of in utero exposure, these effects are likely lower bounds on the overall effects of this exposure.

The Affordable Care Act (ACA) lets young adults stay on their parents' insurance. Several papers use age-time difference-in-differences strategies to argue this causes health insurance and labor effects. I show that difference-in-differences over "placebo" dates also produces statistically significant "effects" before ACA implementation, even with conservative adjustments. This suggests the effects attributed to the ACA could instead reflect dynamics in the age-structure of the health insurance and labor markets. Reducing the age bandwidth yields more reliable estimates of the increases in parental and overall insurance coverage. The key problem in this literature is therefore potentially overstating the ACA's "effects" in other dimensions.

M any women rely on publicly funded family planning and women's health clinics as their only recent source of care, including preventive care (Frost, Gold, and Bucek 2012; Guttmacher Institute 2016). Some of these organizations provide abortion services in addition to family planning and other reproductive health services. Consequently, such organizations may face politically motivated funding cuts, which may also impact important non-abortion outcomes and related services.One primary cause of women's health facility closures is the loss of public funding. In the past few years, several states have attempted and in some cases succeeded in cutting public funding for women's health organizations that provide (or are affiliated with provision of) abortion services. These policies are exogenous to our outcomes of interest: women's cancer screenings and routine checkups. This is clearly stated by one of the state legislators responsible for recent funding changes in Texas,

The government of Texas recently enacted multiple restrictions and funding limitations on women's health organizations that provide abortion services or are associated with those that do. These policies have caused numerous clinic closures throughout the state, drastically reducing access to care. We study the impact of these clinic closures on fertility by combining quarterly snapshots of health center addresses from a network of women's health centers with restricted geotagged data of all Texas birth certificates for 2007-2013. We calculate the driving distance to the nearest clinic for each ZIP code, and find that an increase of 100 miles to the nearest clinic results in a 1.2 percent increase in the birth rate. This increase is driven by fertility changes for unmarried women and those having their first or second child. It also reduces average maternal age.

Mergers that affiliate a hospital with a Catholic owner, network, or system reduce the set of possible reproductive medical procedures since Catholic hospitals have strict prohibitions on contraception. Using changes in ownership of hospitals, we find that Catholic hospitals reduce the per bed rates of tubal ligations by 31%, whereas there is no significant change in related permitted procedures such as Caesarian sections. However, across a variety of measures, we find minimal overall welfare reductions. Still, fewer tubal ligations increase the risk of unintended pregnancies across the United States, imposing a potentially substantial cost for less reliable contraception on women and their partners.