Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives

Abstract

We use changes to Medicaid immediate postpartum policy to test whether non‐monetary costs are meaningful obstacles to health care. Medicaid in several states currently covers long‐acting reversible contraceptives (LARCs, including IUDs and implants) immediately following delivery of a child, eliminating much of the time‐cost and stress associated with obtaining a LARC. Postpartum LARCs can reduce unintended and short‐interval pregnancies, which are associated with adverse neonatal outcomes. Births that occur in Catholic‐owned hospitals are an ideal control group, because these hospitals are prohibited from offering family‐planning services, including LARCs. Using difference‐in‐differences and individual‐level administrative data from Louisiana and New York, we find eliminating non‐monetary obstacles increases take‐up of a high‐value and highly effective form of contraception. Additionally, we find no evidence of crowd‐out of outpatient LARCs.