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Contraceptive Insurance Mandates and Consistent Contraceptive Use Among Privately Insured Women

Magnusson, Brianna M. PhD, MPH*; Sabik, Lindsay PhD; Chapman, Derek A. PhD; Masho, Saba W. MD, DrPH; Lafata, Jennifer Elston PhD§; Bradley, Cathy J. PhD; Lapane, Kate L. PhD

doi: 10.1097/MLR.0b013e318254331c
Original Articles

Introduction: Half of the states in the United States mandate that health insurers cover contraceptives. Health care reform includes recommendations to extend these mandates nationally through the essential benefits package. This study evaluates the association of state-level insurance mandates and consistent contraceptive use among privately insured women aged 15–44.

Study Design: The National Survey of Family Growth (2006–2008) included 2276 privately insured women at risk for unintended pregnancy. Multilevel logistic regression models provided estimates of the association between state-level insurance coverage mandates and consistent contraceptive use.

Results: Among privately insured women, 18% reported a ≥1-month gap in contraceptive use. Compared with women living in states with no mandates, those in states with comprehensive mandates had increased odds of consistent contraceptive use among privately insured women [adjusted odds ratio (aOR), 1.64; 95% confidence interval (CI), 1.08–2.50], but not uninsured women (aOR, 0.77; 95% CI, 0.38–1.55). Partial mandates were not associated with consistent contraceptive use.

Discussion: Consistent contraceptive use among women with private insurance is higher in the states with mandates compared with those without mandates.

*Department of Health Science, College of Life Sciences, Brigham Young University, Provo, UT

Departments of Healthcare Policy and Research

Epidemiology and Community Health

§Social and Behavioral Health, Virginia Commonwealth University, School of Medicine, Richmond, VA

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Supported by a dissertation assistantship from Virginia Commonwealth University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the University. It is also supported in part by Award Number UL1RR031990 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources, National Cancer Institute, or the National Institutes of Health.

Reprints: Brianna M. Magnusson, PhD, MPH, Department of Health Science, College of Life Sciences, Brigham Young University, 229-B Richards Building, Provo, UT 84602. E-mail: brianna_magnusson@byu.edu.

© 2012 Lippincott Williams & Wilkins, Inc.