How Far Is Too Far? New Evidence on Abortion Clinic Closures, Access, and Abortions

Scott Cunningham, Jason M. Lindo, Caitlin Myers, Andrea Schlosser

NBER Working Paper No. 23366
Issued in April 2017, Revised in January 2018
NBER Program(s):Children, Health Care, Health Economics, Law and Economics, Public Economics

We estimate the effects of abortion-clinic closures on clinic access and abortions using variation generated by Texas HB2, a “TRAP” law that shuttered nearly half of Texas' abortion clinics in late 2013. Our results suggest a substantial and non-linear effect of distance to clinics. Increases from less than 50 miles to 50-100, 100-150, and 150-200 miles reduce abortion rates by 15, 25, and 40 percent, respectively, while additional increases in distance appear to have no additional effect. We also introduce a proxy for congestion that captures the potential for there to be effects of closures which have little impact on distance but which reduce per-capita capacity. We demonstrate that this is also an important mechanism through which closures affect abortion; moreover, ignoring this mechanism causes the effects of distance to be somewhat overstated. Several features of the data imply that magnitude of the effects on abortion are too big to be explained by interstate travel. That said, the results of a simulation exercise demonstrates that the effects are too small to plausibly be detected in analyses of birth rates.

You may purchase this paper on-line in .pdf format from ($5) for electronic delivery.

Access to NBER Papers

You are eligible for a free download if you are a subscriber, a corporate associate of the NBER, a journalist, an employee of the U.S. federal government with a ".GOV" domain name, or a resident of nearly any developing country or transition economy.

If you usually get free papers at work/university but do not at home, you can either connect to your work VPN or proxy (if any) or elect to have a link to the paper emailed to your work email address below. The email address must be connected to a subscribing college, university, or other subscribing institution. Gmail and other free email addresses will not have access.


The NBER Bulletin on Aging and Health provides summaries of publications like this.  You can sign up to receive the NBER Bulletin on Aging and Health by email.

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w23366

Users who downloaded this paper also downloaded* these:
Fischer, Royer, and White w23634 The Impacts of Reduced Access to Abortion and Family Planning Services on Abortion, Births, and Contraceptive Purchases
Bailey and Lindo w23465 Access and Use of Contraception and Its Effects on Women’s Outcomes in the U.S.
Clark, Pinkovskiy, and Sala-i-Martin w23323 China's GDP Growth May be Understated
Piketty, Yang, and Zucman w23368 Capital Accumulation, Private Property and Rising Inequality in China, 1978-2015
Cawley, de Walque, and Grossman w23334 The Effect of Stress on Later-Life Health: Evidence from the Vietnam Draft
NBER Videos

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email:

Contact Us