Background: We wanted to focus on the potential consequences of recently enacted legislation in Texas that limits adolescents’ability to obtain confidential reproductive health care services. Objective: To assess the potential economic costs that result when adolescents do not seek reproductive health care services because their confidentiality is compromised. Design: We developed a cost model to estimate the projected costs of parental consent and law enforcement reporting requirements based on data from the literature, the Texas Department of Health, and publicly funded family planning clinics in Texas. Univariate and multivariate sensitivity analyses explored different scenarios. Setting: The state of Texas. Participants: Projected costs were estimated for all girls younger than 18 years using publicly funded reproductive health care services in Texas. Main Outcome Measures: We determined the projected number of additional pregnancies, births, abortions, and untreated sexually transmitted infections and resulting pelvic inflammatory disease and calculated the associated economic costs of these projected outcomes. Results: The potential costs of parental consent and law enforcement reporting requirements in Texas were estimated at ＄43.6 million (range, ＄11.8 million to ＄56.6 million) for girls younger than 18 years currently using publicly funded services. Conclusions: As policymakers throughout the United States search for ways to curtail adolescent sexual activity and its adverse consequences, this analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences.
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