Implementing the Birth Control Mandate

Under the Patient Protection and Affordable Care Act of 2010 (ACA), most women of reproductive age with private health insurance have, or will soon have, first-dollar coverage of contraception and contraceptive counseling. The need for contraceptive coverage is great, because most American families want two children, resulting in the average woman spending three decades of her reproductive life trying to avoid pregnancy (Guttmacher Institute, 2012Finer and Philbin, 2014). Contraceptive coverage without cost sharing is a sea change in women's health insurance. This policy change has the potential to dramatically shift contraceptive use patterns, to reduce the U.S. unintended pregnancy rate—which stands at approximately half of all pregnancies (Finer & Zolna, 2014)—and to improve the health of women and families. In this commentary, we argue that realizing the potential of this policy change requires more action on the part of public health practitioners, insurers, health care providers, and researchers than is currently evident, and we offer some suggestions for making the most of first-dollar contraceptive coverage.

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