One of the stated objectives of the Patient Protection and Affordable Care Act was to ensure that more American women were able to have access to a range of birth control methods at little or no cost to themselves. That objective is being met, according to a study published in the journal Contraception.
The research was conducted by the Guttmacher Institute, which surveyed 4,634 women before PPACA's implementation, during its initial phases, and, most recently, in the spring of 2014.
"The findings of this study suggest that the federal contraceptive coverage guarantee has had a substantial impact in eliminating out-of-pocket costs among privately insured women using some methods of contraception — including oral contraceptives, the most popular reversible method in the United States," researchers said. "Between fall 2012 and spring 2014, the proportion of pill users paying zero dollars out of pocket increased from 15 percent to 67 percent, with similar trends for injectable, ring and IUD users. Further progress may still be expected as more private health plans become subject to the requirement."
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While the leap in oral contraceptive coverage was impressive, the proportion of privately insured U.S. women who paid zero dollars out of pocket coverage for other methods increased as well from the fall of 2012 to spring 2014. For example:
- Vaginal ring increased from 20 percent to 74 percent;
- Injectable contraceptives increased from 27 percent to 59 percent;
- IUD increased from 45 percent to 62 percent.
"This analysis shows that the contraceptive coverage guarantee under the ACA is working as intended," said Adam Sonfield, senior public policy associate at the Guttmacher Institute and lead author of the study. "Large numbers of women are now able to obtain highly effective birth control methods without co-pays or deductibles, making it easier for them to choose the method they can use most consistently and effectively to avoid an unplanned pregnancy."
Researchers said the percentage of women who will pay nothing for birth control methods will never reach 100 percent, owing to such factors as "federal guidelines that allow insurers to charge co-payments in limited situations" and exemptions on religious grounds for some employers.
Overall, though, the researchers were pleased with the study's findings.
"That these benefits continue to accrue so quickly is remarkable, and shows that the contraceptive coverage guarantee is meeting a real demand," Sonfield said. "Its impact will only continue to grow as its protections are phased in."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
