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Health Aff (Millwood). 2015 Jul;34(7):1204-11. doi: 10.1377/hlthaff.2015.0127.

Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

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Nora V. Becker ( is an MD/PhD candidate in the Department of Health Care Management and Economics in the Wharton School, University of Pennsylvania, in Philadelphia.
Daniel Polsky is executive director of the Leonard Davis Institute of Health Economics, a professor of medicine in the Perelman School of Medicine, and the Robert D. Eilers Professor of Health Care Management in the Wharton School, all at the University of Pennsylvania.


The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance.


Health Reform; Health Spending; Insurance Coverage < Insurance

[Indexed for MEDLINE]

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