Factors Associated with New Uptake of Long-Acting Reversible Contraceptives Since the Affordable Care Act Among Privately Insured Women in Pennsylvania

Hallie N. Nelson, Elizabeth Thayer, Celeste Bailey, Laura Leuenberger, Erik Lehman, Cynthia H. Chuang

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: The Affordable Care Act eliminated out-of-pocket costs for contraceptives, including highly effective long-acting reversible contraception (LARC), for most insured women. Patient characteristics associated with new LARC uptake after the Affordable Care Act have not been well-studied. We hypothesized that awareness of no-cost intrauterine device (IUD) coverage would be associated with new LARC use. Methods: Data included were from 883 women not using a LARC at baseline who participated in the MyNewOptions study, a 2-year study of privately insured women in Pennsylvania. Multivariable analysis assessed whether the following baseline characteristics predicted new LARC use over 2 years: awareness of no-cost IUD coverage, future pregnancy intention, baseline contraceptive use, contraceptive attitudes, and sociodemographic characteristics. Results: At baseline, 54.4% of participants were using prescription methods; 21.1% nonprescription methods; 12.1% natural family planning, withdrawal, or spermicide alone; and 12.5% no method. A minority (7.2%) was aware of no-cost coverage for IUDs. Over 2 years, 7.2% of participants became new LARC users, but awareness of no-cost coverage for IUDs was not associated with new LARC use (adjusted odds ratio, 0.84; 95% confidence interval, 0.27–2.55). New LARC use was associated with already using prescription methods, not intending pregnancy within the next 5 years, prior unintended pregnancy, and desire to change method if cost were not a factor. Conclusions: Among privately insured women, wanting to switch methods if cost were not a factor was associated with new LARC uptake, although awareness of no-cost IUD coverage was not. Providing women with information about their contraceptive coverage benefits may help women to seek and obtain the methods better aligned with their personal needs.

Original languageEnglish (US)
Pages (from-to)370-375
Number of pages6
JournalWomen's Health Issues
Issue number5
StatePublished - Sep 1 2019

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery


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