Contraceptive Insurance Coverage Has Improved Dramatically
Nearly nine in 10 group insurance plans purchased by employers for their employees now cover a full range of prescription contraceptives—three times as many as just a decade ago, a new study from The Alan Guttmacher Institute shows. The study, "U.S. Insurance Coverage of Contraceptives and the Impact of Contraceptive Coverage Mandates, 2002," by Adam Sonfield et al., also finds that state laws played a critical role in this improvement. Better insurance coverage and improved method choice should improve each woman’s ability to choose the contraceptive method that is best suited to her needs rather than choosing the method that best fits her budget.
Improvements since The Alan Guttmacher Institute’s first study of private insurance coverage of reproductive health services in 1993 have been profound. In 2002, 86% of employer-purchased plans typically covered the full range of contraceptive methods, compared with just 28% in 1993; the proportion of plans covering no method at all plummeted from 28% to only 2% during this period. In addition, 20 states now have laws in place requiring insurers to provide contraceptive coverage to their employees if they cover other prescription drugs. Plans in states with these laws have significantly more-extensive coverage than plans that are designed specifically to provide coverage in states without such mandates.
A companion analysis, "New Study Documents Major Strides in Drive for Contraceptive Coverage," by Adam Sonfield and Rachel Benson Gold summarizes and discusses the implications of this federally funded study. Differences in insurance coverage and cost can discourage a woman from choosing the most appropriate contraceptive method for her health and lifestyle. Equalizing coverage across a broad range of methods enables each woman to choose—with fewer concerns over cost—the method that she is most likely to use effectively to prevent unintended pregnancy.
Despite advances in contraceptive coverage, significant gaps remain: Half of all U.S. women live in the 30 states that do not require plans to cover contraceptives, and plans designed for these states offer inferior coverage compared with plans designed for mandate states. In addition, about half of all Americans with employer-based insurance coverage obtain that coverage from employers who choose to self-insure, rather than purchase a plan from an insurance company. By law, self-insured plans are exempt from state coverage requirements, and the extent of contraceptive coverage in self-insured plans nationally is unknown.
"Dramatic improvements in insurance coverage show that 10 years of advocacy for contraceptive coverage is working," says Sharon Camp, President and CEO of The Alan Guttmacher Institute. "More privately insured women now have more affordable contraceptive choices and a real opportunity to choose methods they can use consistently and correctly. At the same time, continued advocacy is needed to close the gaps that remain," said Camp, "by enacting state mandates in those states that do not yet have them, fully enforcing federal law prohibiting gender discrimination and, enacting federal legislation that will cover all privately insured Americans once and for all."
This study was supported by grant FPR00072 from the U.S. Department of Health and Human Services.
Rebecca WindGuttmacher Institute