Panel Paper: Mandating Prescription Contraception Coverage: The Effects On Contraceptive Consumption, Fertility, and Sexual Health

Friday, November 9, 2012 : 1:20 PM
Pratt B (Sheraton Baltimore City Center Hotel)

*Names in bold indicate Presenter

Leonard Lopoo and Kerri Raissian, Syracuse University

Over the last several months there has been considerable debate regarding Health and Human Service’s decision to mandate health insurance coverage of prescription contraceptives. While this issue has reached the public’s attention only recently, this policy is not a new one. Beginning in the 1990s, some states mandated that insurance providers include prescription contraception and contraceptive devices in their policies’ coverage. To date, however, the effects of these mandates and expanded coverage are unknown.  Yet in addition to the benefits of evaluating existing policy, understanding the effects of these state-level policies could help inform the national debate.  We will use a variety of data sources to better understand how these insurance mandates affected women’s consumption choices and their well-being.  Our identification will come from state-level policy variation: approximately 28 states adopted “mandate to cover” laws and they adopted these policies over the span of several years.  We will use a differences-in-difference estimator to determine if women in states with mandated prescription contraception coverage increased their consumption of contraception relative to women in states without mandated coverage.  We will also investigate if, following the policy change, certain women were more likely to change their contraceptive use or choices relative to others.  Our primary data source for this question is the MEPS (Medical Expenditure Panel Survey).  If contraceptive use changed following the adoption of insurance mandates, we will use a variety of data sources to determine the consequences of this contraceptive shift.  We will extend this research design to ask how this change affected fertility rates (using NCHS’s vital statistics birth files and, starting in 2005, VitalStats from the Centers for Disease Control [CDC]) for all women and sub-groups of interest.  Similarly, we will ask if mandated coverage affected the sexual health of women in states where prescription contraception coverage is mandated compared to women in states without mandated coverage.  Sexually transmitted diseases (STDs) will serve as at least one measure of sexual health.  Our measures of STDs come from the CDC Wonder data extraction tool.