Impact of the Affordable Care Act on Use of Covered Contraceptives in Women Ages 20-25.

Although many impacts of the Affordable Care Act (ACA) have been well studied, less attention has been paid to whether use of contraceptives (especially those covered by health insurance) changed in young adults. The ACA did several things that might influence contraceptive use: allowed children to stay on a parent's health insurance until age 26, required insurers to impose no co-payment for contraceptives beginning in 2012, and increased funding for family planning services. The authors examined data from the National Survey of Family Growth for 3 time periods: 2006-2010 (pre ACA), 2011-2013, and 2013-2015 (post ACA). In the earlier data set, 50% of female respondents ages 20 to 25 were using a prescribed form of birth control; by 2011-2013, the percentage using prescribed birth control rose to 89% (CI 95%: 0.83 - 0.92). However, by 2013-2015, the percentage of women using prescribed birth control had decreased to 55%, a nonsignificant change from 2006-2010. The percentage of respondents ages 20 to 25 reporting health insurance coverage for 6 months or more grew slightly, from 77% in 2006-2010 to 80% in 2013-2015. The ACA encouraged significantly more young adult women to increase their use of prescribed (or otherwise covered by health insurance) birth control methods over non-prescribed methods during 2011-2013; however, use returned to nearly pre-ACA levels by 2015. In a nationally representative sample, the percentage of young women insured increased only slightly after the ACA took effect.