Access for All: Providing Contraception to Women Under the Affordable Care Act of 2010

As part of the Patient Protection and Affordable Care Act of 2010 (ACA), preventive services, including all FDA-approved contraceptive methods, will be provided at no cost to women with private insurance. Although all prescription contraceptive methods have proven to be cost-effective, the scope of the potential impact of this policy has yet to be explored. A secondary data analysis of the 2009 Medical Expenditure Panel Survey was conducted to assess differences in the rates of prescription contraception use among women with private health insurance, women with public health insurance, and uninsured women. Based on Chi Square analyses of women using contraception (n = 1,003), we found significant differences in the likelihood of using prescription contraception based on insurance status, age, race/ethnicity, education level, and relationship status. An additional comparison shows that those women who reported being likely to take risks (somewhat agree or strongly agree) are also significantly less likely to use prescription contraception (p<0.05). The data provide information on the sizeable potential for two important behavioral outcomes to be observed once the barrier of cost is removed: (1) women who do not currently use prescription contraception will utilize a method; and (2) women who currently use less costly methods—which also are the methods with the highest potential for user error and unintended pregnancy—will upgrade to the more highly effective methods. Increased utilization of contraception, specifically the most highly effective methods of contraception, may impact the high rate of unintended pregnancy in the United States.