The Power of the Payor: Exploring the Effect of Mandated Infertility Treatment Coverage on Female Labor Outcomes

Abstract

Between 1980 and 2000, thirteen US states enacted policies mandating insurance coverage for infertility treatments, generating plausibly exogenous variation in access to reproductive technologies. Employing a series of differences-in-differences regressions that exploit variation in mandates across states and years, I estimate the causal effect of increased access to infertility treatments on female labor market outcomes. I extend this analysis with a triple-difference model, examining differential labor trends across age cohorts. The results reveal a consistent pattern of reduced labor force participation in the years following mandate implementation, relative to women in untreated states. Although wage income effects are less robust, there is a general upward trend in income, particularly in states with more comprehensive legislation. These findings suggest that expanded access to infertility treatments has meaningful consequences for women’s labor market behavior.