14 Jul Women’s Out-of-Pocket Expenses For Contraceptives Drop After ACA
Medical Research: What is the background for this study? What are the main findings?
Response: The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device (IUD) insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the IUD and $255 annually for the oral contraceptive pill.
Medical Research: What should clinicians and patients take away from your report?
Response: Privately-insured patients should take away from our study that their financial options for contraception have changed because of the ACA. More effective, longer-term methods like IUD or the implant used to require a large up-front payment of several hundred dollars, and now should be available without any copays and deductibles. Clinicians, especially those who provide well-woman services, should mention this to their patients as well. This is still a new law and many women may not realize that their insurance coverage has changed.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: The next big question for researchers is how will these changes in out-of-pocket price affect the rates of birth control use in the U.S. There are two types of contraceptive use that could be affected. Overall rates of use of any birth control method could increase, and the distribution of methods chosen could also change. How women respond to these price changes will depend on how price-sensitive they are to the out-of-pocket cost of contraceptives. There is not much research on this in the U.S., but what little we have suggests that women may be fairly price-insensitive, suggesting that perhaps overall rates of use might not change substantially. I’d speculate that where we are more likely to see a response is in the type of method chosen; women may choose longer-term methods at higher rates now that the up-front cost of these methods has been lowered to zero. It’s too soon to know for sure what the final effects will be; this is an area where it will be important to continue studying the long-term impacts of the ACA.
Nora V. Becker MD/PhD candidate (2015). Women’s Out-of-Pocket Expenses For Contraceptives Drop After ACA