204672 Contraception access after health care reform: A preliminary look at the impact of mandatory insurance coverage in Massachusetts

Tuesday, November 10, 2009: 10:50 AM

Amanda Jo Dennis, MBE , Ibis Reproductive Health, Cambridge, MA
Kelly Blanchard, MS , Ibis Reproductive Health, Cambridge, MA
Denisse Córdova, MPH , Law School, University of Pennsylvania, Philadelphia, PA
Britt Wahlin , Ibis Reproductive Health, Cambridge, MA
Jill Clark, MPH , Family Planning Program, Massachusetts Department of Public Health, Boston, MA
Karen Edlund, RN , Family Planning Program, Massachusetts Department of Public Health, Boston, MA
Jennifer McIntosh, PharmD, MHS , Family Planning Program, Massachusetts Department of Public Health, Boston, MA
Lenore Tsikitas, MPH , Family Planning Program, Massachusetts Department of Public Health, Boston, MA
Background:

In 2006, Massachusetts passed legislation mandating all residents have health insurance by July 2007. Because women have less access to employer-sponsored insurance and earn less than men, an insurance mandate could pose a significant financial burden for low-income women.

Purpose:

We explored the impact of health care reform on low-income women's access to contraception.

Methods:

This study has four components: (1) systematic review of subsidized health insurance plans (2) self-administered surveys of family planning agencies (3) in-depth interviews with family planning clinic staff (4) eight focus groups with low-income English and Spanish speaking women across Massachusetts.

Results:

Data collection will be completed in February 2009. Preliminary findings show that though reform has enormous benefits for some women, many women, such as adolescents, undocumented immigrants, women with incomes at or around the financial cutoffs or with variable employment continue to face barriers in accessing care. Women identified multiple obstacles to maintaining insurance coverage, noting they frequently lose coverage, which may affect contraceptive use. Additionally, they indicate they receive little information about which contraceptive methods are covered under their plans; plan websites provide inadequate information about which methods are covered and how much they cost. The presentation will include analysis of data from clinics and more in-depth information on women's experiences.

Conclusion:

Health care reform should explicitly address access to contraception for low-income women. Lessons learned from Massachusetts's experience should inform other state or national health care reform.

Learning Objectives:
1)List barriers that low-income women face in accessing contraception after health care reform in Massachusetts. 2)Discuss key issues for addressing contraception in debates around health care reform.

Keywords: Contraception, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I was the project director of the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.