• Womens Health Issues · Mar 2017

    Patient Education About the Affordable Care Act Contraceptive Coverage Requirement Increases Interest in Using Long-Acting Reversible Contraception.

    • Julia C Durante and Elisabeth J Woodhams.
    • Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address: julia.durante@jefferson.edu.
    • Womens Health Issues. 2017 Mar 1; 27 (2): 152-157.

    BackgroundThe Patient Protection and Affordable Care Act (ACA) requires health insurance to cover all Food and Drug Administration-approved contraceptives at no cost to patients, including highly effective long-acting reversible contraception (LARC). Our objective was to determine whether a brief educational intervention about these provisions would increase interest in LARC use.MethodsThis is a cross-sectional survey of women seeking contraceptive care in an urban outpatient obstetrics/gynecology clinic. We collected baseline contraceptive attitudes and knowledge of the ACA's contraceptive coverage provisions before the intervention. Our primary outcome was interest in using a LARC method before and after reading a short description of the ACA's contraceptive coverage provisions.ResultsSurveys were completed by 316 participants. Most participants (52.8%) could not correctly identify any of the contraception coverage stipulations protected under the ACA. We observed a significant increase in LARC interest after the intervention in all participants (37.3% vs. 44.3%; p = .038), primarily among participants who did not originally identify any ACA provisions correctly (n = 167; 38.3% vs. 48.5%; p = .030). This subset also demonstrated a greater adjusted odds ratio of post-intervention LARC interest (odds ratio, 2.889; 95% CI, 1.234-6.723; p = .014). Interest in short-acting reversible contraception and contraception overall remained unchanged.ConclusionsMost women seeking birth control lack comprehensive understanding of the contraceptive coverage protected by the ACA. Incorporating patient education about the ACA's no-cost contraception provision into routine contraceptive counseling may increase interest in LARC use and better enable women to make informed family planning decisions unrestrained by financial considerations.Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

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