Study: Out-of-pocket contraception spending dropped under ACA

Average out-of-pocket spending per contraception claim fell from $16 in 2011 to $1.73 in 2014

BOSTON (SHNS) – Spending by Massachusetts women on prescription contraceptives dropped sharply under the federal health care law known as the Affordable Care Act, according to data scheduled to be released Monday by the state’s Health Policy Commission.

While the U.S. Senate prepares to take up a new health care bill intended to replace the Affordable Care Act, Health Policy Commission staff are sharing a summary of their findings this week in New Orleans at the annual Academy Health Research Conference.

After examining commercial insurance data between 2011 and 2014, the commission found the percentage of prescription contraception claims with patient cost-sharing fell from 98 percent to 6.5 percent, with a decrease in average out-of-pocket spending per contraception claim falling from $16 in 2011 to $1.73 in 2014.

The Affordable Care Act, passed in 2010, requires health plans to cover contraceptives, without co-pays, as a preventative service.

“Following the passage of the ACA, Massachusetts women experienced significant improvements in affordability and access for high-value contraceptive care and services,” Health Policy Commission executive director David Seltz said in a statement. “Federal action has the potential to erode these gains, resulting in impacts to health spending and outcomes.”

The study found that while use of prescription contraception in Massachusetts remained relatively constant from 2011 to 2014, at roughly 1.2 million claims, the number of women using the long-acting contraceptive known as intrauterine devices or IUDs rose 34 percent, from 13,800 to 18,500. The researchers conclude that this suggested “increased use of more effective methods of contraception,” possibly driven by greater affordability.

Average out-of-pocket spending on IUDs fell 81 percent, from $28.11 to $5.27 over the same time period, while the percentage of women with any patient cost-sharing for IUDs dropped from 52 percent to 7 percent, the Health Policy Commission found.

“As more recent data on birth rates and abortion rates become available, it will be important to monitor trends in these measures following periods of more affordable access to contraception,” the study said. “As changes in national health care legislation remain uncertain, these findings can provide context for discussions about maintaining preventive and contraceptive coverage at the state level.”

With the final details of any new federal health care legislation still unknown, state lawmakers are taking steps to maintain coverage of contraception in Massachusetts if the requirement is stripped.

Bills filed by Reps. Patricia Haddad and John Scibak and Sen. Harriette Chandler (H 536, S 499) — and backed by groups including the ACLU of Massachusetts, Progressive Massachusetts and the Women’s Bar Association — would require Bay State insurers to cover all FDA-approved contraceptive methods without cost-sharing, including over-the-counter contraceptives.

A House working group convened to guide the branch’s response to the Trump Administration on Tuesday plans to discuss the Haddad/Scibak bill. Haddad, the House speaker pro tempore, helms the working group with Majority Leader Ron Mariano.

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