Contraceptive insurance mandates and consistent contraceptive use among privately insured women

摘要

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.