Access to contraception after health care reform in Massachusetts: a mixed-methods study investigating benefits and barriers

Background: In 2006, Massachusetts passed sweeping health care reform legislation aimed at improving access to health care for residents. This study investigates how this landmark legislation affected contraceptive access for low-income women.

Study design: This study included (a) 16 in-depth interviews with family planning providers, (b) 9 focus group discussions with 52 low-income English- and Spanish-speaking women, (c) 10 self-administered surveys of family planning administrators and (d) a systematic review of Web sites for government-subsidized insurance plans.

Results: Findings from all study components were highly consistent. We found that while most low-income women in Massachusetts continue to regularly obtain contraception, challenges such as maintaining insurance coverage, understanding benefits, securing an appointment with a provider and obtaining prescriptions were identified post reform. Findings about contraceptive affordability under reform were mixed.

Conclusion: Though health care reform legislation has benefited many women, barriers remain to ensuring consistent access to contraception for low-income women.