Abortion and Economic Policy, Part I: “Personal Rights Shape Economic Mobility”

The economy and reproductive rights are two of the most important issues for voters—indeed, a growing number of young women in particular say that abortion policies are key to their decision this November. But abortion and the economy are not entirely separate policy domains. In this new series for Fireside Stacks, Roosevelt’s Hannah Groch-Begley interviews experts who study the economics of reproductive rights. For our first conversation, we sat down with Kate Bahn, chief economist and senior vice president of research at the Institute for Women’s Policy Research (IWPR), and Melissa Mahoney, senior research economist at IWPR.

This interview has been edited and condensed for clarity. 

Hannah Groch-Begley: This election cycle, we’ve heard a lot about abortion as health care or a matter of personal rights. But today we want to think about how this is an economic policy issue. I want to start big picture. IWPR analysis shows that restrictions on abortion cost the US economy tens of billions per year. Where does that figure come from? Can you walk us through where you’re getting that cost and put that into context for us?

Kate Bahn: The concept at the heart of this is that personal rights shape economic mobility. As individuals, we can understand that being able to exercise your own rights shapes how you engage in the broader world. But what does that mean, practically, when we do this modeling as economists? The model that IWPR has created is based on a large literature showing that access to reproductive health care—and abortion particularly—shapes women’s ability to engage in the labor market and their labor force participation, which, in turn, shapes state economies. So the more than $60 billion figure is from states that have bans on abortion care. We see tens of billions of dollars in costs when a state has severe restrictions on access due to the impact on labor force participation, affecting their overall state economy. On the other hand, in states that offer really strong protections on health care, women can engage more in the labor market—over $40 billion is saved by the fact that some states are still protecting women’s rights.

Melissa Mahoney: In addition to impacting women’s labor force participation, there’s an additional impact of reducing wages for women. If a woman exited the labor force for some time due to having a child, her wages tend to be reduced when she reengages. So there’s that additional economic cost there that we account for in our model.

Hannah: Let’s break that down a little bit. When we’re talking about labor force participation, why is that so influenced by whether or not you have access to something like abortion? What is the domino effect happening that we could see that personal decision reflected at the state and national level?

Melissa: The way that I think about it is that in the absence of access to abortion care, it’s more likely that unwanted pregnancies are going to be brought to term. An additional number of unwanted pregnancies brought to term means that we’re more likely to see childcare responsibilities placed on women. And we see in the economic literature that one of the reasons why women have reduced labor force participation or exit the labor force is due to childcare responsibilities. So there’s a direct connection between having access to abortion care, having access to reproductive health care, and individuals’ ability to dictate when and if to have children. And that choice, that ability, will directly impact their ability to engage in the labor market.

Kate: I think about it as the indirect and direct impacts. The direct impacts are those unplanned fertility outcomes. Having a baby when you didn’t expect to have a baby costs money. It costs money anytime, but when you’re not planning on it, it’s much harder to cope with those costs. And then I think about the indirect costs: How you decide to participate in the labor market is also dependent on a sense of security and the ability to know when and how you will have children. I think it makes a big difference when and how you decide to have children, if you do it, when you plan to do it. And so maybe that impacts whether someone decides to get a graduate degree because they don’t know if they’re going to be able to have certainty over that. Maybe it impacts what kind of work hours they take or if they want to move far away from family. There are all these indirect consequences on how women engage in the labor market.

Hannah: You mentioned that your work distinguishes states that are more restrictive and states that are less restrictive in terms of access to abortion. Could you break that down for us? What does the landscape look like currently, and how are you determining more restrictive, less restrictive in your research?

Melissa: The last time we gathered the abortion policy data was for a new report that’ll be released in a few days. There we classify 18 states as the most restrictive or in a “total ban” category. Just to give you a sense of what that looks like: A state like Alabama would be in this category because there is a full ban on abortion access with few exceptions. Georgia is also in that category. There’s not a full state ban in effect, but they ban anything past six weeks, so we have them in this most restricted category. Many of these states fall in the southern region of the United States, the Southeast, and in the Midwest. And then in terms of the most protected, we have 13 states. We see those along the West Coast and up in the Northeast—those are the states that are offsetting the costs of the most restrictive states.

Hannah: And this data is up to date as of the 2022 Dobbs Supreme Court ruling?

Kate: Yes. The new report is up-to-date as of August 2024. The tricky thing about doing research on the topic is that it is a rapidly changing legal landscape, and you have to decide when to cut off a project and what labor market data timeline to refer to. Georgia is a great example. There was a six-week gestational limit, which is equivalent to a ban, since most people don’t know they’re pregnant by six weeks. And then they had a court battle that challenged the ban, and one week later the ban was back in place. And so this is a tricky thing, as a researcher doing this work, that it’s so rapidly changing across all the states. The broad framing of restrictive and protective holds true, but the details are rapidly shifting.

Hannah: You talked about labor force participation, and the direct and the indirect costs. That kind of constantly changing legal landscape, I’m sure, is also complicated for the women living in these states and is affecting their ability to plan their personal finances ahead, to think about jobs long-term.

Melissa: I see two parts to this. One is the impact of this rapidly changing policy landscape on individual women’s choices related to their careers. When these confusing scenarios emerge, like what we see in Georgia, you could be really confused about whether you want to take a new job or whether you want to move states or something. Then there’s also a question about medical providers and the impact of this ever-changing policy landscape on provision of OB-GYN care in certain states. People in those professions are moving out of state, because they don’t want to get caught in some sort of political or legal minefield. Folks who are going to practice medicine in those states are maybe not picking up those particular areas of expertise, because the experts they could learn from have all left. Which just exacerbates an already existing problem of access to reproductive health care in those states.

Hannah: We’ve certainly seen news stories of hospitals being unwilling to treat women who need miscarriage care because, it seems, the doctors are concerned about what their lawyers will say.

We’ve talked a little bit about how this breaks down along state lines, and that, depending on what state you live in, you’re going to experience this quite differently. How are there other ways in which this data breaks down along race and class lines as well?

Melissa: There are big discrepancies with where people live, both in terms of demographic representation and, of course, now in terms of access to abortion providers. So we disaggregated the labor force. We looked at where women, by race, were residing in terms of abortion policy. We found that overall, for all women, roughly 50 percent of prime-age (ages 25 to 54) working women were living in states with total bans or restrictions on abortion access. And for Black women, this number rises to nearly 60 percent.

Kate: The broad, overarching way I think about this topic is that we know that marginalization begets marginalization. We know that if you’re facing barriers in some contexts, it exacerbates the likelihood that you face barriers in other contexts. I think of previous research that looks at, for example, TRAP laws, or Targeted Restrictions of Abortion Providers, which were some of the most extreme types of abortion restriction prior to Dobbs. An example of a trap law is medically unnecessary facility requirements like clinics having the same standards as surgical centers. People may remember the Supreme Court Case regarding Whole Women’s Health in Texas where the Supreme Court in 2016 overturned a Texas TRAP law that led to the closure of the vast majority of abortion clinics in the state. The research showed that in states that had these really extreme TRAP laws, it increased the likelihood of Black teens not finishing high school and not starting college, which then has long-term adverse effects on their economic well-being. And I think that’s partly because Black teens are already facing a harder time. They’re more likely to be from low-wealth families. They’re less likely to have access to high-quality health care. These other intersecting barriers, these structural barriers that a Black teenager is likely to face, exacerbate the impact of those TRAP laws.

Hannah: I’d love to hear some policy solutions. Are there specific angles that you think that policymakers should be considering?

Melissa: Congress should take action to protect abortion access at the national level. In particular, they should overturn the Hyde Amendment, which restricts the use of federal dollars for abortion care. Outside of the federal level, some states are establishing their own constitutional protections to access to abortion care or pursuing other options like setting up shield laws, which protect against legal ramifications related to providing necessary health care.

Also, we’re hearing some particularly troubling issues, like lawmakers in Texas wanting to dig into patients’ medical records in order to determine whether or not patients in state sought medical care for abortion outside of state. So at the state level, we can also work to establish and maintain strong privacy protections around medical records.

Kate: We also need to do something to address OB-GYN deserts, because that both impacts women seeking abortion care, but it also impacts all people who need to have OB-GYN care, and that’s going to have subsequent impacts on their economic well-being too. If you don’t have access to OB-GYN care when you do want a child, that might impact your maternal health outcomes, which might impact your economic outcomes as well. So I think we need to have some sort of targeted policy, whether it be on the state or federal level, to address the serious maternal health-care crisis.

More broadly, thinking about what reproductive justice means, it means women’s ability to make fully informed decisions with agency and the right to parent with dignity. And I think if we want women making fully informed decisions about their family planning and whether, when, and how to have children, we also need women to have access to the broad suite of social supports that help them parent with dignity: things like access to good food, high-quality education and childcare, affordable housing. Research from the Turnaway Study led by Diana Greene Foster found that women who sought an abortion but were denied due to gestational limits were also more likely to report financial hardship later, including eviction and bankruptcy, so they could neither make their own family planning decisions nor fully parent with dignity.

Melissa: One of the things that we find, generally speaking, is lower rates of health insurance coverage for women in ban states compared to the national average and states with protections. Again, focusing on that prime working-age population for all workers and for women workers. This is likely due to ban states generally having smaller economies, lower labor force participation, and some of them not expanding Medicaid. So that’s something concerning we should look at policy-wise.

Hannah: I feel like there’s always more research to do than we have the resources for. What do you wish you could be diving into? What’s missing from this conversation?

Kate: I will say the amount of research being done on this topic has exploded in the past five years or so, definitely since Dobbs—but also before Dobbs, I saw it really expanding. I remember when Melissa and I started doing this research, it was hard to find previous research that was looking at abortion restrictions and economic outcomes. And now it’s a pretty big field.

There’s some research looking at fertility impacts since Dobbs, that finds an increase in fertility for women in banned states. A recent study by Dench, Pineda-Torres, and Myers found that birth rates increased by about 2.5 percent in states with abortion bans. That translates to roughly 30,000 more births than we would’ve seen if Roe hadn’t been overturned. This effect was especially pronounced among young people, people of color, and those living in states where access to clinics was more limited. At the same time, nationally, there’s been an increase in abortion in the first six months after Dobbs, and that might be partly a blip based on additional funding going toward access to abortion. But understanding the direct impact of Dobbs just takes time.

Melissa: There was this period of research that some researchers call the period of liberalization. A couple of years before Roe, a few states liberalized access to abortion, and that research has told us some interesting things about the impact of abortion access on women’s educational outcomes, women’s labor force outcomes, things like that. Ever since Roe, we see a period of contraction of access to abortion, through things like TRAP laws and states not allowing public funding for abortions.

I think moving forward it will be interesting from an economic and research point of view—horrifying from a personal point of view—but seeing what this period of contraction is doing to those same important economic and labor market outcomes. And as Kate rightly said, it’s just a matter of time, moving further out from 2022, with all the lags and economic data, before we can actually study some of these things.

The other thing that I’m interested in is occupational mobility between states based on abortion policies in the state. Are you able to change jobs, seek better opportunities, better pay, and things like that? Are people moving due to these laws? As we move forward and have more access to data, post-Dobbs, we might be able to say something about that. Even if it’s a small finding, I think that would be a really interesting contribution to the literature, for sure.

Hannah: Just anecdotally, I was considering a job in Texas and didn’t pursue it. I can confirm that these abortion laws were absolutely part of my rationale. It wasn’t the only reason, but it was a pretty significant one for someone my age, who is thinking about this kind of thing. It would be fascinating to be able to study that in a more systematic way.

Melissa: Our next IWPR report on these topics comes out Tuesday, October 29, titled The Economic and Workforce Impact of Health Care Matters for Employers, and we dig into a lot of the themes that we talked about throughout this conversation: The impact of the reproductive health-care landscape on labor market outcomes, economic outcomes, and also maternal mortality and fertility outcomes throughout the United States over the past couple of years.

This affects us all, right? It affects the overall economy. It affects people who may be considering expanding their families. For employers, it’s going to affect who’s working for them. It’s going to affect the health of their labor force. It’s going to affect productivity. This is a really wide, broad, overarching issue that everybody should be interested in.

If You Ask Eleanor 

“What do you think should be done in this country to encourage larger families?

In European countries bonuses have been paid, but I should think in this country that cheaper medical and hospital care, higher wages, better farm income—in fact, more economic security—would mean a lessening of maternal and infancy morality and would probably be the American answer to the question.

”

– Eleanor Roosevelt, My Day (May 23, 1963)