Katie Magoon1, Claire Beamish2, Nadia Dowshen3, Aletha Akers3. 1. Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Katie.magoon@gmail.com. 2. Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 3. Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Abstract
STUDY OBJECTIVE: Long-acting reversible contraceptives (LARCs) are the most effective form of pregnancy prevention for sexually active adolescents, yet usage rates are low. The Affordable Care Act (ACA) mandated insurers cover LARCs without cost-sharing. Compliance with this policy is not well documented. This study assessed LARC coverage by insurers in a large pediatric health system. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: Between June and August 2016, LARC coverage was assessed through content reviews of insurance Web sites, formularies, and summaries of benefits for all Pennsylvania Medicaid plans and the top 20 commercial insurers for a large pediatric health system. MAIN OUTCOME MEASURES: The primary outcome was adherence to the ACA mandate for LARC coverage without cost-sharing. RESULTS: Among the 37 plans (17 public, 20 private), 21 (56.8%) were adherent and 16 (43.2%) were nonadherent. Among nonadherent plans, 3 plans covered LARC services but required cost-sharing, whereas 13 did not cover LARC services at all. There was not a statistically significant difference in LARC coverage between public and private plans. CONCLUSION: Despite the landmark ACA mandate, insurance coverage of LARCs in pediatric hospitals is low for young women among private and public insurers. Insurer failure to adhere to the ACA among pediatric patients represents a barrier to LARC access for those at high risk of unintended pregnancy.
STUDY OBJECTIVE: Long-acting reversible contraceptives (LARCs) are the most effective form of pregnancy prevention for sexually active adolescents, yet usage rates are low. The Affordable Care Act (ACA) mandated insurers cover LARCs without cost-sharing. Compliance with this policy is not well documented. This study assessed LARC coverage by insurers in a large pediatric health system. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: Between June and August 2016, LARC coverage was assessed through content reviews of insurance Web sites, formularies, and summaries of benefits for all Pennsylvania Medicaid plans and the top 20 commercial insurers for a large pediatric health system. MAIN OUTCOME MEASURES: The primary outcome was adherence to the ACA mandate for LARC coverage without cost-sharing. RESULTS: Among the 37 plans (17 public, 20 private), 21 (56.8%) were adherent and 16 (43.2%) were nonadherent. Among nonadherent plans, 3 plans covered LARC services but required cost-sharing, whereas 13 did not cover LARC services at all. There was not a statistically significant difference in LARC coverage between public and private plans. CONCLUSION: Despite the landmark ACA mandate, insurance coverage of LARCs in pediatric hospitals is low for young women among private and public insurers. Insurer failure to adhere to the ACA among pediatric patients represents a barrier to LARC access for those at high risk of unintended pregnancy.
Authors: Brooke Winner; Jeffrey F Peipert; Qiuhong Zhao; Christina Buckel; Tessa Madden; Jenifer E Allsworth; Gina M Secura Journal: N Engl J Med Date: 2012-05-24 Impact factor: 91.245
Authors: Veronica X Vela; Elizabeth W Patton; Darshak Sanghavi; Susan F Wood; Peter Shin; Sara Rosenbaum Journal: Womens Health Issues Date: 2018-01-10