Contraceptive insurance mandates and consistent contraceptive use among privately insured women.
BACKGROUND
Half of the states in the United States mandate that health insurers cover contraceptives. Health care reform includes recommendations to extend these mandates nationally through the essential benefits package. This study evaluates the association of state-level insurance mandates and consistent contraceptive use among privately insured women aged 15-44.


METHODS
The National Survey of Family Growth (2006-2008) included 2276 privately insured women at risk for unintended pregnancy. Multilevel logistic regression models provided estimates of the association between state-level insurance coverage mandates and consistent contraceptive use.


RESULTS
Among privately insured women, 18% reported a ≥1-month gap in contraceptive use. Compared with women living in states with no mandates, those in states with comprehensive mandates had increased odds of consistent contraceptive use among privately insured women [adjusted odds ratio (aOR), 1.64; 95% confidence interval (CI), 1.08-2.50], but not uninsured women (aOR, 0.77; 95% CI, 0.38-1.55). Partial mandates were not associated with consistent contraceptive use.


CONCLUSIONS
Consistent contraceptive use among women with private insurance is higher in the states with mandates compared with those without mandates.
Department of Health Science, College of Life Sciences, Brigham Young University, Provo, Utah 84602, USA. brianna_magnusson@byu.edu
Brianna M
BM
Magnusson
Lindsay
L
Sabik
Derek A
DA
Chapman
Saba W
SW
Masho
Jennifer Elston
JE
Lafata
Cathy J
CJ
Bradley
Kate L
KL
Lapane
D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000191:economics / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007356:Insurance, Pharmaceutical Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D037141:Mandatory Programs / Q000191:economics*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D012959:Socioeconomic Factors; D013219:State Government; D014481:United States; D016387:Women's Health; D055815:Young Adult
D003271:Contraceptive Agents, Female