Glenn
Cohen (Harvard) and my new colleague Daniel Chen (Duke – Welcome Daniel!) have posted Trading-Off
Reproductive Technology and Adoption: Does Subsidizing in Vitro Fertilization
Decrease Adoption Rates and Should it Matter? to SSRN. I read this paper in draft form over the summer and quite
enjoyed it, so I’ll be back next week with some more detailed thoughts on Cohen
and Chen’s paper and its implications.
At the moment, though, the first week of classes and obligations next
week over at the Conglomerate
Junior Scholars Forum are keeping me busy. Here’s the abstract:
For those facing infertility, using
assisted reproductive technology to have genetically related children is a very
expensive proposition. In particular, to produce a live birth through in vitro
fertilization (IVF) will cost an individual (on average) between $66,667 and
$114,286 in the U.S. If forced to pay these prices out of pocket, many would be
unable to afford this technology. Given this reality, a number of states have
attempted to improve access to reproductive technology through state-level insurance
mandates that cover IVF. Several scholars, however, have worried that
increasing access in this way will cause a diminution in adoptions and have
argued against enactment of state mandates for that reason.
In this paper, which was selected for
presentation at the 2010 Stanford-Yale Junior Faculty Forum, we push against
that conclusion on two fronts.
First, we interrogate the normative
premises of the argument and expose its contestable implicit assumptions about
how the state should balance the interests of existing children waiting for
adoption and those seeking access to reproductive technology in order to have
genetically related children.
Second, we investigate the unexamined
empirical question behind the conclusion: does state subsidization of
reproductive technologies through insurance mandates actually reduce adoption;
that is, is there a trade-off between helping individuals conceive and helping
children waiting to be adopted? We call the claim that there is such an effect
the “substitution theory.” Using the differential timing of introduction of
state-level insurance mandates relating to IVF in some states and differences
in the forms these mandates take, we employ several different econometric
techniques (differences-in-differences, ordinary least squares, two-stage least
squares) to examine the effect of these mandates on IVF utilization and
adoption. Contrary to the assumption of the substitution theory, we find no
strong evidence that state support of IVF through these mandates crowds out
either domestic or international adoption.