by Amber Burkhart, Health Policy Fellow
When the Affordable Care Act (ACA) passed in 2010, it was clear that women’s health was a priority. The ACA not only guarantees coverage at more affordable costs for women, but it also covers more preventive care services that benefit women’s health. One of the ACA’s fundamental mandates is the requirement that insurance plans cover contraceptives at no cost; these include a full range of FDA-approved contraceptive methods and counseling. These services provide women and their families with more options to choose the care they need, when they need it.
One contraceptive option rising in popularity and controversy is Long Acting Reversible Contraception (LARC). This contraceptive method, which has stirred up significant debate at the Colorado State Legislature, is proven to be safe and effective at reducing unintended birth and abortion rates. The legislature is deciding this session whether to grant funding to the Department of Public Health and Environment (CDPHE) to continue their Colorado Family Planning Initiative, which, between 2009 and 2013, made LARC more widely available to low-income women. Currently, the funding for this program will end in June 2015.
How has LARC benefitted Colorado?
As a result of the Family Planning Initiative, the birth rate among Colorado women ages 15 to 19 dropped 40 percent and the abortion rate fell by 42 percent. This is a huge success for Colorado! Not only does LARC reduce unintended pregnancy and abortions, but it also leads to less demand for state-funded entitlement programs such as Medicaid. According to Colorado state departments, for every dollar invested in the LARC program, an estimated $5.85 in Medicaid costs was avoided within a three-year period.
Unfortunately, LARC is still often difficult to afford. In 2013, CDPHE’s Women in Need Research found that 275,000 Colorado women still need better access to the most effective forms of contraception. The Kaiser Family Foundation Coverage of Contraceptive Services report released earlier this month illuminates one reason for this cost barrier. The report found that there is variation in how the contraceptive coverage provision of the ACA is being interpreted and implemented by health plans. Despite the ACA mandate that requires insurance plans to cover contraceptives at no cost, some insurers still limit access to certain types of birth control, particularly IUDs, the patch and ring.
Insurance carriers are legally able to place limitations on coverage of contraceptive methods by using “reasonable medical management,” which allows an insurer to pick which contraceptive options will be cheaper to provide. For example, IUDs are typically inserted in a physician’s office or an outpatient setting and therefore can be expensive to purchase and insert. Continuing to fund the Family Planning Initiative will help remove this cost barrier and increase access to birth control for low-income women.
The ACA has made great strides to give women more opportunities to make healthy choices for themselves and their families. Providing greater access to affordable Long Acting Reversible Contraception is an important step to ensuring that all women benefit from the ACA’s vision. By investing a small amount of state funds in a proven, effective program, LARC supports the health and well-being of all women in Colorado.