Family Planning Waivers and Teen Fertility - Revised

描述（由申请人提供）：计划生育豁免和青少年生育青少年怀孕在美国被广泛认为是一个严重的问题，寻找预防青少年怀孕的方法是一项重要的公共政策目标。通常建议的一种办法是改善获得计划生育服务的机会。在医疗补助计划的支持下，一些州一直在试验一项正是这种性质的政策。这些州最近获得了联邦政府的豁免，允许他们向更多的妇女提供医疗补助计划生育服务。已批准的豁免包括将收入资格扩大到贫困线的200%的政策，以及将产后5年计划生育服务的权利扩大到产后5年的政策。我们提出的研究将通过评估这些医疗补助计划生育豁免的影响来评估计划生育服务在减少青少年怀孕和生育方面可能发挥的作用。我们建议进行的研究将采用一种实证策略，专门针对确定所提供的额外服务与生育结果之间的因果关系。我们计划在我们的分析中使用几个数据来源，包括生命统计出生数据，疾病控制和预防中心和艾伦古特马赫研究所提供的堕胎数据，以及来自全国家庭增长调查的性行为和避孕使用数据。我们将在分析中采用准实验技术，检查出生结果及其前件（性行为、避孕、怀孕和流产）。随着时间的推移，我们将利用地理上的差异来引入豁免，将那些没有发生政策变化的地区作为伪对照组，以帮助衡量政策对那些提供额外计划生育服务的地区的因果影响。我们还将比较各州和各年的结果，比较那些更有可能有资格参加豁免计划的人和那些由于收入较高而不太可能有资格参加豁免计划的人。我们计划对所有青少年和按种族/民族分开的青少年进行分析，以确定群体之间是否存在差异影响。

DESCRIPTION (provided by applicant): FAMILY PLANNING WAIVERS AND TEEN FERTILITY Teen pregnancy is widely acknowledged as a serious problem in the United States and finding ways to prevent teen pregnancy is an important public policy goal. One approach that is commonly suggested is to improve access to family planning services. Some states have been experimenting with a policy of precisely this nature under the auspices of their Medicaid programs. These states have recently been granted waivers from the federal government allowing them to extend the provision of Medicaid family planning services to more women. Those waivers that have been granted include policies to expand income eligibility to up to 200 percent of the poverty threshold and to extend the right to family planning services for up to 5 years post-partum. The research we propose will evaluate the role that family planning services may play in reducing teen pregnancies and births by estimating the impact of these Medicaid family planning waivers. The study we propose to conduct will employ an empirical strategy specifically targeted at identifying a causal connection between the additional services provided and fertility outcomes. We plan to use several sources of data in our analysis, including Vital Statistics Natality data, abortion data available from the Centers for Disease Control and Prevention and from the Alan Guttmacher Institute, and data on sexual behavior and contraceptive use from the National Survey of Family Growth. We will employ quasi- experimental techniques in our analysis, examining birth outcomes as well as its antecedents (sexual activity, contraception, pregnancy, and abortion). We will take advantage of the geographic variation over time in the introduction of the waivers, treating those locations in which no policy change took place as a pseudo-control group to help gauge the causal impact of the policy in those locations that offered additional family planning services. We will also compare outcomes across states and across years for those more likely to be eligible for the waiver programs and those who are less likely to be eligible due to their higher income. We plan to conduct this analysis for all teens and for teens separated by race/ethnicity to determine whether there is a differential impact across groups.