The effect of contraceptive access reform on privately insured patients: Evidence from Delaware Contraceptive Access Now

Many states are implementing comprehensive programs aimed at reducing persistent barriers to contraceptive care. Evidence on the effectiveness of these programs is essential for practice improvement and policy development. To evaluate changes in the probability of initiating a contraceptive method b...

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Bibliographic Details
Published in:PloS one 2023-01, Vol.18 (1), p.e0280588-e0280588
Main Authors: Yoder, Maranna, Boudreaux, Michel
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biology and Life Sciences
Birth control
Childbirth & labor
Contraception - methods
Contraceptive Agents
Contraceptives
Delaware
Earth Sciences
Employers
Engineering and Technology
Family planning
Female
Finance
Health aspects
Health care reform
Health insurance
Health Services Accessibility
Hospitalization
Humans
Insertion
Insurance
Insurance, Health
Intrauterine Devices
Medicaid
Medicine and Health Sciences
Methods
Oral contraceptives
Patients
Perceptions
Population studies
Pregnancy
Reforms
Reimbursement
Reproductive health
Secondary analysis
Social Sciences
United States
Young Adult
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Summary:Many states are implementing comprehensive programs aimed at reducing persistent barriers to contraceptive care. Evidence on the effectiveness of these programs is essential for practice improvement and policy development. To evaluate changes in the probability of initiating a contraceptive method by women with employer sponsored insurance after implementation of Delaware Contraceptive Access Now (DelCAN), a statewide initiative that aimed to increase access to long-acting reversible contraceptives (LARCs). We used a difference-in-differences design to examine contraceptive initiation rates. Data came from IBM Marketscan and covered women age 15-44 enrolled in employer sponsored insurance. The primary outcome was insertion of a LARC, both in the overall study population and in the immediate postpartum (IPP) setting. Secondary analysis examined changes to other contraceptive method types. The cohort of 4,550,459 enrollees generated a sample of 11,888,837 person-years and 615,670 childbirth hospitalizations. Difference-in-differences estimates suggested that DelCAN was associated with a 0.3 percentage point (95% CI [0.2, 0.5], p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0280588