Prescription contraceptive use in young women: Are there differences by health insurance status?

Background: Women's health has been widely discussed during Congress' attempts to overhaul the health care system. Any expansion of insurance eligibility will have a profound impact on young women—the group least likely to have private coverage—and their ability to prevent or plan future pregnancies. However, it is unclear whether prescription contraceptives should be a mandatory component of the minimum benefits package. This study investigates the relationship between health insurance status and use of prescription contraceptives among young women. By examining these factors, policymakers can make informed decisions about required family planning benefits that may enhance access to contraception across social position. Methods: Data from Wave III of the Add-Health public use data set were analyzed. The sample included 1,916 women at risk for pregnancy. Logistic regression was used to test the likelihood of prescription contraceptive use between the uninsured and those with private insurance or public insurance, controlling for a range of sociodemographic and sexual health factors. Results: Among the study participants, about 20% were uninsured, 70% had private insurance, and 10% had public insurance. Almost 70% used a prescription contraceptive. In multivariate analysis, the privately insured were significantly more likely than the uninsured to use prescription contraceptives (aOR =1.57, CI: 1.18-2.09). No significant difference was found between public insurance recipients and the uninsured (aOR=1.35, CI: 0.85-2.14). Conclusions: Lack of insurance may hinder women's ability to choose prescription contraceptives. Health insurance reform should require coverage of a full range of contraceptive options in any basic benefits package.