The Affordable Care Act's (ACA) contraception mandate expanded birth control coverage, making Long Acting Reversible Contraception (LARC) more accessible. Anecdotal reports suggest that concerns about loss of coverage following the November 2016 election would lead more women to seek LARC. We conducted a cross-sectional survey to investigate whether women choosing LARC cite politics as a motivation and if they support the ACA.
All women undergoing LARC insertion from June 2017 to July 2017 in an urban gynecology office were invited to participate. Non-English speakers were excluded. The survey queried demographics, motivation for selecting LARC and support for ACA. Descriptive statistics were used to summarize data and chi square tests were used to assess associations between views.
97 women presented for LARC insertion and 84 completed the survey (86% response rate). 80% received IUDs and 20% received Nexplanon. 99% of devices were paid for by patient insurance. 38% stated recent political events influenced their decision to get LARC. 87% were in favor of the ACA and 86% supported the contraception mandate. Those who supported the ACA were significantly more likely to specifically support the contraception mandate (93% vs 40%, p <0.01). However, women who did not support the ACA were not more likely to support its repeal (25% vs 13%, p=0.38).
A majority of the women seeking LARC support the ACA and for more than one third, the election affected their decision. Politics impacts patient choices and physicians may need to address the changing political climate to better serve their patients.