Regulation, Imperfect Competition, and the U.S. Abortion Market

Abstract

The market for abortion in the U.S. has become increasingly concentrated in recent years, while many states have tightened abortion regulations aimed at providers. Using unique data on abortion providers I estimate an equilibrium model of demand, price competition, entry and exit, which captures the effect of regulation on the entire market. The estimates show that regulations played an important role in determining the structure and evolution of the abortion market. Counterfactual simulations reveal increases in demand-aimed regulation was the single most important observed factor explaining recent declines in abortion. Simulating Utah's strict regulatory regime over the sample period reveals that tightening abortion restrictions can actually increase the number of abortions in equilibrium, mainly through tilting the competitive landscape toward lower-priced providers. * We thank

Assessing the impact of TRAP laws on abortion and women’s health in the USA: a systematic review

“…Studies in our review tended to agree that TRAP laws were associated with a decrease in provider availability, with one reporting a loss of 46% of all Texas providers in the year following HB2 enforcement 5. The relationship between policies and providers was particularly central to one analysis20 that was principally concerned with the behaviour of the abortion market in response to regulations. This study reported that TRAP laws decreased market entry rates for clinics and increased the cost of procedures by approximately 10%.…”

“…Depending on the analysis, the magnitude of this effect ranged from a 6.8% decline in the abortion rate among women aged 18–30 years,21 to a 13% decline in the abortion rate among all women of childbearing age (15–44 years),5 to a 72% decrease in the abortion rate among women presenting at or after 16 weeks’ gestation 18. In contrast, one study in this subgroup found no effect of TRAP laws on abortion demand,19 and one reported a potential increase in abortions following TRAP legislation 20. Both of these studies concluded that demand-side policies (particularly parental consent laws) play a more significant role than supply-side policies in explaining the contemporary decline in abortion rates 19 20…”

“…The third Texas-based analysis18 examined the effects of an earlier law – the Women’s Right to Know Act (WRTK) – which stipulated that all abortions at or after 16 weeks' gestation must be performed in an ASC. Studies at the national level assessed a comparatively wider range of regulations: one19 used data from NARAL (a reproductive rights advocacy group) to group state-level TRAP laws into two categories (licensing fees, plant/personnel laws), and another20 used the same source but grouped TRAP laws according to a six-category classification scheme. The remaining study21 assessed the impact of supply-side regulations indirectly by simulating the effect of TRAP-driven provider closures on the national scale.…”

The Consequences of Abortion and Contraception Policies on Young Women's Reproductive Choices, Schooling and Labor Supply

“…After knowing if they became pregnant, they decide whether to work part-time, full-time, or not 1 Henshaw et al (2009), Joyce et al (2009), and Dennis et al (2009) summarize the findings of the literature for Medicaid funding restrictions, mandatory counseling requirements and parental consent requirements, respectively. Beauchamp (2012) has shown that, between 1991 and 2005, supply-side regulation led to an annual average decrease of 5.86% in the number of counties with a provider.…”

“…For instance, Cook et al (1999) find that, among eligible women, 37% of the pregnancies that would have ended in abortion were carried to term, a result that is consistent with the later analysis of Morgan and Parnell (2002). Finally, with respect to the supply-side restrictions, Beauchamp (2012) estimates a dynamic model of entry and exit of providers to the abortion market. He finds that restrictions imposed on providers lead to the concentration of abortion services in fewer and bigger abortion clinics, decreasing the number of providers and thus access to abortion services.…”