ArticleMedical care2016
Early Impact of the Affordable Care Act on Uptake of Long-acting Reversible Contraceptive Methods.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: A systematic literature review.Journal of managed care & specialty pharmacy · 2023Pooled it
- Effect of universal no-cost coverage on use of long-acting reversible contraception and all prescription contraception: population based, controlled, interrupted time series analysis.BMJ (Clinical research ed.) · 2025Article
- Reproductive decision making in women with medical comorbidities: a qualitative study.BMC pregnancy and childbirth · 2023Article
- Article
- Association of the National Dependent Coverage Expansion With Insurance Use for Sexual and Reproductive Health Services by Female Young Adults.JAMA network open · 2020Article
- Trends in Birth Rates After Elimination of Cost Sharing for Contraception by the Patient Protection and Affordable Care Act.JAMA network open · 2020Article
- Pulling back the curtain on trends in contraceptive use in recent years: what can we predict for the future?F&S reports · 2020Article
- Evaluation of Medicaid Expansion Under the Affordable Care Act and Contraceptive Care in US Community Health Centers.JAMA network open · 2020Article
- The Affordable Care Act contraception mandate & unintended pregnancy in women of reproductive age: An analysis of the National Survey of Family Growth, 2008-2010 v. 2013-2015.Contraception · 2020Article
- Insurance Plan Adherence to Mandate for Long-Acting Reversible Contraceptives in a Large Pediatric Hospital Network.Journal of pediatric and adolescent gynecology · 2019Article
- Access to contraception in local health departments, four Midwest states, 2017-2018.Contraception · 2019Article
- Prescription Contraceptive Sales Following the Affordable Care Act.Maternal and child health journal · 2019Article
- Association of Access to Family Planning Services With Medicaid Expansion Among Female Enrollees in Michigan.JAMA network open · 2018Article
- Long-Acting Reversible Contraception Free of Charge, Method Initiation, and Abortion Rates in Finland.American journal of public health · 2018Article
- Effect of Providing Contraception Free of Charge.American journal of public health · 2018Article
- Motivations for Interest, Disinterest and Uncertainty in Intrauterine Device Use Among Young Women.Maternal and child health journal · 2017Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundThe Affordable Care Act (ACA) required most private insurance plans to cover contraceptive services without patient cost-sharing as of January 2013 for most plans. Whether the ACA's mandate has impacted long-acting reversible contraceptives (LARC) use is unknown.
objectiveThe aim of this article is to assess trends in LARC cost-sharing and uptake before and one year after implementation of the ACA's contraceptive mandate.
designA retrospective cohort study using Truven Health MarketScan claims data from January 2010 to December 2013. SUBJECTS: Women aged 18-45 years with continuous insurance coverage with claims for oral contraceptive pills, patches, rings, injections, or LARC during 2010-2013 (N=3,794,793). MEASURES: Descriptive statistics were used to assess trends in LARC cost-sharing and uptake from 2010 through 2013. Interrupted time series models were used to assess the association of time, ACA, and time after the ACA on LARC cost-sharing and initiation rates, adjusting for patient and plan characteristics.
resultsThe proportion of claims with $0 cost-sharing for intrauterine devices and implants, respectively, rose from 36.6% and 9.3% in 2010 to 87.6% and 80.5% in 2013. The ACA was associated with a significant increase in these proportions and in their rate of increase (level and slope change both P<0.001). LARC uptake increased over time with no significant change in level of LARC use after ACA implementation in January 2013 (P=0.44) and a slightly slower rate of growth post-ACA than previously reported (β coefficient for trend, -0.004; P<0.001).
conclusionsThe ACA has significantly decreased LARC cost-sharing, but during its first year had not yet increased LARC initiation rates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.