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Peer-reviewedCC BY-NC-ND 4.0Health Economics

The Fertility Reduction Effects of the Colorado Family Planning Initiative by Age and Parity

7 affiliations
  1. 1Department of Economics Miami University Oxford Ohio USA
  2. 2University of Colorado Boulder Institute of Behavioral Science (IBS) Boulder Colorado USA
  3. 3Institute of Labor Economics (IZA) Bonn Germany
  4. 4Department of Sociology University of Colorado Boulder Boulder Colorado USA
  5. 5Department of Health and Behavioral Sciences University of Colorado Denver Denver Colorado USA
  6. 6United States Census Bureau Suitland Maryland USA
  7. 7Department of Sociology and Demography Stockholm University Stockholm Sweden

Abstract

We use restricted‐access birth records from the National Vital Statistics System (NVSS) to document the full age and parity fertility effects of the Colorado Family Planning Initiative (CFPI). The CFPI provided access to every FDA approved method of contraception for free to anyone living below approximately 200% of the federal poverty line from 2009 to 2015. Previous research has demonstrated important effects on fertility at ages 15–29. We estimate the statewide fertility effect of the CFPI for all age groups (15–44) and for all births and for first and non‐first births using the synthetic control method. We find large and statistically significant reductions in birth rates for 15–24‐year‐olds that largely line up with other recent studies, but we find important heterogeneity across parity. For teenagers, we find reductions in first birth rates of about 9%, but much larger reductions in non‐first birth rates of 17%–25%. We also find reductions in overall fertility for 20–24 and 25–29‐year‐olds, but these are entirely driven by reductions of 5%–9% in non‐first birth rates, with no significant changes in first births. For 30–39‐year‐olds, we find small but statistically significant reductions in fertility of 3%–7% across parity levels, and we find a 6% reduction in fertility for 40–44‐year‐olds. We also conduct inference using synthetic difference‐in‐differences (SDID) and placebo‐based methods. When we do this, our coefficient estimates are similar, though confidence intervals are wider, with specifications on older age groups no longer statistically significant.

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BibTeX
@article{flynn2026fertility,
  title = {{The Fertility Reduction Effects of the Colorado Family Planning Initiative by Age and Parity}},
  author = {James Flynn and Amanda Stevenson and Sara Yeatman and Katie Genadek and Jane Menken and Stefanie Mollborn and Leslie Root},
  journal = {Health Economics},
  year = {2026},
  month = aug,
  doi = {10.1002/hec.70147},
  url = {https://doi.org/10.1002/hec.70147},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - The Fertility Reduction Effects of the Colorado Family Planning Initiative by Age and Parity
AU  - James Flynn
AU  - Amanda Stevenson
AU  - Sara Yeatman
AU  - Katie Genadek
AU  - Jane Menken
AU  - Stefanie Mollborn
AU  - Leslie Root
PY  - 2026
DA  - 2026/08/08
JO  - Health Economics
DO  - 10.1002/hec.70147
UR  - https://doi.org/10.1002/hec.70147
AB  - We use restricted‐access birth records from the National Vital Statistics System (NVSS) to document the full age and parity fertility effects of the Colorado Family Planning Initiative (CFPI). The CFPI provided access to every FDA approved method of contraception for free to anyone living below approximately 200% of the federal poverty line from 2009 to 2015. Previous research has demonstrated important effects on fertility at ages 15–29. We estimate the statewide fertility effect of the CFPI for all age groups (15–44) and for all births and for first and non‐first births using the synthetic control method. We find large and statistically significant reductions in birth rates for 15–24‐year‐olds that largely line up with other recent studies, but we find important heterogeneity across parity. For teenagers, we find reductions in first birth rates of about 9%, but much larger reductions in non‐first birth rates of 17%–25%. We also find reductions in overall fertility for 20–24 and 25–29‐year‐olds, but these are entirely driven by reductions of 5%–9% in non‐first birth rates, with no significant changes in first births. For 30–39‐year‐olds, we find small but statistically significant reductions in fertility of 3%–7% across parity levels, and we find a 6% reduction in fertility for 40–44‐year‐olds. We also conduct inference using synthetic difference‐in‐differences (SDID) and placebo‐based methods. When we do this, our coefficient estimates are similar, though confidence intervals are wider, with specifications on older age groups no longer statistically significant.
SN  - 1057-9230
SN  - 1099-1050
ER  -