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Study: Affordable Care Act Has Significantly Increased Number of Women Who Can Access Contraception Without a Co-Pay

According to the results of a new study, the Affordable Care Act has led to a significant increase in the number of privately insured women who can access contraception without a co-pay.

The study, conducted by Guttmacher Institute researchers Lawrence B. Finer, Adam Sonfield, and Rachel K. Jones and published in the journal Contraception, found that the proportion of privately insured women who did not have to pay for access to oral contraceptive pills rose from 15 percent to 40 percent after the ACA’s birth control coverage went into effect in January 2013. They found a similar increase for privately insured users of the vaginal ring, from 23 percent to 52 percent.

“Our analysis provides the first quantitative evidence that the cost-sharing protection under the ACA is indeed working as intended,” said Finer, director of domestic research at the Guttmacher Institute and lead author of the study, in a statement. “Large numbers of women who couldn’t previously do so are now obtaining birth control without co-pays or deductibles, which allows them to more easily attain contraception’s well-documented health, social and economic benefits.”

Among other provisions aimed at improving women’s health and health care services, the Affordable Care Act includes a requirement that private health plans include coverage of contraceptive methods, services and counseling for women, and that they do so without requiring copays, deductibles or other forms of out-of-pocket costs. Although the law is not applicable to all health plans and enrollees (certain grandfathered plans and employer-provided plans for those working at religious organizations are exempt from the contraception mandate), the results of this study indicate that the federal contraceptive coverage requirement is already having a substantial impact in eliminating out-of-pocket costs for contraception among privately insured women. Further, researchers say that more progress can be expected in the next several months and years as more private health insurance plans become subject to the contraceptive coverage requirement.

For many women in the U.S., the cost of birth control is a major barrier to contraceptive access. The high price of birth control can result in women using birth control inconsistently – or not at all. Women of reproductive age spend 68% more than men on out-of-pocket health care costs, largely because of contraceptive costs. And although women pay an average of 33% of the total cost for non-contraceptive prescription medications, most privately insured women pay out-of-pocket fees totaling about 50% of the cost of contraception. Results from a nationwide survey indicate that one in three women  (34%) in the U.S. have struggled with the cost of prescription birth control, and more than half (55%) of young adult women experienced a time when they could not afford to use birth control consistently.

The Affordable Care Act’s requirement for contraceptive coverage ensures that all women can choose the method that works best for them, reducing the risk of unintended pregnancies and giving women control over their reproductive health and health care. According to the authors from the Guttmacher Institute,

“The findings of this study bode well for the health and well-being of women, couples and families. Government bodies and private sector experts have long recognized contraceptive services as a vital and effective component of preventive and public health care, and an extensive body of research shows that contraceptive use helps women avoid unintended pregnancy and improve birth spacing, resulting in substantial health, social and economic benefits. The new federal requirement, in giving women coverage without cost sharing of a wide range of contraceptive choices, may help them overcome financial barriers to choosing a contraceptive method they will be able to use consistently and effectively.”


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