In this paper, we estimate the impacts of abortion clinic closures on access to clinics in terms of distance and congestion, abortion rates, and birth rates. Legislation regulating abortion providers enacted in Wisconsin in 2011-2013 ultimately led to the closure of two of five abortion clinics in Wisconsin, increasing the average distance to the nearest clinic to 55 miles and distance to some counties to over 100 miles. We use a difference-in-differences design to estimate the effect of change in distance to the nearest clinic on birth and abortion rates, using within-county variation across time in distance to identify the effect. We find that a hundred-mile increase in distance to the nearest clinic is associated with 25 percent fewer abortions and 4 percent more births. We see no significant effect of increased congestion at remaining clinics on abortion rates. We find significant racial disparities in who is most affected by abortion clinic closures, with increases in distance increasing birth rates significantly more for Black, Asian, and Hispanic women. Our results suggest that even small numbers of clinic closures can result in significant restrictions to abortion access of similar magnitude to those seen in Texas when a greater number of clinics closed their doors.
There are (at least) two possible responses to such results, and that is without even getting into one’s underlying view of the ethics of abortion. One is to say that a great deprivation has occurred because many fewer women end up having abortions. Another response is to infer that the marginal value of the abortions could not have been so high to begin with, if the number drops off so readily.
The same issue comes up with Obamacare. If the price of health insurance goes up, quite a large number of people decide to go without coverage. Is the size of that number a measure of the human tragedy resulting from the price increase? Or is it a measure of how little those people actually value health insurance? Or somehow both?
I have yet to meet a person who can think through these issues rationally and absorb what is interesting and valid in each of those two perspectives.