Impact of Medicaid family planning eligibility expansion on contraceptive use of low income women
Monday, November 4, 2013
: 12:30 p.m. - 12:45 p.m.
Introduction: This study estimates the impact of Medicaid family planning waivers on the use of more effective contraceptive methods among low income women at risk of unintended pregnancy. Methods: We identified 1,736 low-income (<185%FPL) women without private insurance, at risk for unintended pregnancy from the 2006-10 National Survey of Family Growth. State-level policy data and contextual data from the NSFG were merged to the NSFG public use file for the analysis. States were classified based on 2006 status as having: 1) income based expansions, 2) expansions for those losing Medicaid coverage, 3) No Medicaid expansions (reference). Contraceptive use in the month of interview was classified as: 1) female sterilization 2) prescription methods 3) over-the-counter methods which may be covered by Medicaid 4) methods unlikely to be covered by Medicaid and 5) No method used (reference). Polytomous logistic regression was conducted. Results: In the sample, 39% of women lived in a state with an income-based expansion. The most commonly used methods were sterilization (44.5%) and prescription contraceptives (25%). Approximately 10% of women reported no method use. Compared to women living in no-expansion states, those living in states with income waivers were no more or less likely to use more effective contraceptive methods [AORsterilization:0.97 (95%CI 0.50-1.89); AORprescription 1.28 (0.68-2.39); AORotc 0.49 (0.24-1.02); AORuncovered: 0.99 (0.38-2.60)]. There were similar findings for women living in limited expansion states. Conclusions: Medicaid family planning waivers may not be reaching women in need of publicly funded contraceptive services and additional research should be conducted.
Public health or related public policy
Evaluate the extent to which state-level Medicaid family planning waivers increase contraceptive use among low-income U.S. women.
Keyword(s): Contraception, Medicaid
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been the principal author on several studies evaluating contraceptive use and women's reproductive outcomes. I have training in epidemiology with specific interest in reproductive policy and behaviors.
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.