U.S. insurance coverage of contraceptives and the impact of contraceptive coverage mandates, 2002

Perspect Sex Reprod Health. 2004 Mar-Apr;36(2):72-9. doi: 10.1363/psrh.36.72.04.

Abstract

Context: In 1993, coverage of reversible contraception by U.S. health insurance plans was extremely low. Little is known about how coverage has changed since then, particularly in response to state mandates.

Methods: In 2001-2002, a nationally representative sample of 205 health care insurers responded to a survey about coverage of reproductive health care services in "typical" employment-based managed care plans (excluding self-insured plans). Data were analyzed to compare coverage in states with and without contraceptive coverage mandates, and to show trends in coverage between 1993 and 2002.

Results: In 2002, almost every reversible contraceptive service and supply studied was covered by at least 89% of typical plans; 86% of plans covered the five leading prescription methods (the diaphragm, one- and three-month injectables, the IUD and oral contraceptives). Coverage of each contraceptive service and supply studied was higher in 2002 than in 1993 (78-97% vs. 32-59%). Plans in states with mandates were significantly more likely to cover the five leading prescription methods (87-92%, depending on type of plan) than were those designed locally in states without mandates (47-61%). Between 1993 and 2002, state mandates were estimated to account for 30% and 40% of the increase in coverage of oral contraceptives and the three-month injectable, respectively.

Conclusions: Coverage of reversible contraception--and by extension, choice within a range of covered methods--has increased substantially since 1993, in part because of state mandates. This state-by-state approach, however, has inherent limitations that can best be dealt with at the federal level.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Contraception / economics*
  • Contraceptive Agents / economics*
  • Family Planning Policy / legislation & jurisprudence*
  • Family Planning Services / organization & administration*
  • Family Planning Services / standards
  • Female
  • Health Promotion / standards*
  • Health Services Accessibility
  • Humans
  • Insurance Coverage* / standards
  • Male
  • Managed Care Programs / organization & administration*
  • Managed Care Programs / standards
  • Quality Assurance, Health Care
  • State Health Plans / standards
  • Surveys and Questionnaires
  • Time Factors
  • United States

Substances

  • Contraceptive Agents