MP51-07 CONTRACEPTION IN THE ERA OF THE AFFORDABLE CARE ACT

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life & Shared Decision Making II1 Apr 2018MP51-07 CONTRACEPTION IN THE ERA OF THE AFFORDABLE CARE ACT Anuj S. Desai, Alicia Roston, James Wren, Mary Kate Keeter, Mehul S. Patel, Matthew T. Hudnall, Minh N. Pham, Lauren F. Cooley, Nelson E. Bennett, and Robert E. Brannigan Anuj S. DesaiAnuj S. Desai More articles by this author , Alicia RostonAlicia Roston More articles by this author , James WrenJames Wren More articles by this author , Mary Kate KeeterMary Kate Keeter More articles by this author , Mehul S. PatelMehul S. Patel More articles by this author , Matthew T. HudnallMatthew T. Hudnall More articles by this author , Minh N. PhamMinh N. Pham More articles by this author , Lauren F. CooleyLauren F. Cooley More articles by this author , Nelson E. BennettNelson E. Bennett More articles by this author , and Robert E. BranniganRobert E. Brannigan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1638AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Affordable Care Act (ACA) mandates coverage of female contraceptives for all new plans after August 1, 2012. Four years after implementation of the ACA contraceptive mandate (ACAM), national health insurance rates (NHIR) have improved, but it is unknown whether the law has impacted patterns in contraceptive use. Our objective was to characterize whether utilization of contraceptives in males and females is associated with changes in NHIR from 2006 -2015. METHODS We analyzed data on 43,303 men and women from the National Survey of Family Growth 2006-2010 and 2011-2015 (NSFG) surveys to obtain national projections of NHIR and last method of contraception (LMC). Accounting for the NSFG study design, survey respondents were clustered by date of interview [June, 2006 - June, 2008 (Group A), July, 2008 - June, 2010 (Group B), September, 2011-September, 2013 (Group C), and October, 2013- September, 2015 (Post ACA)] as well as by LMC [Tier 1 (condoms, spermicide, withdrawal, rhythm), Tier 2 (pill, patch, vaginal ring, injectable), Tier 3 (intrauterine device or implant), Tier 4 (vasectomy), and Tier 5 (female surgical sterilization). Linear regression (r2) was used to assess LMC over time from June, 2006 to September, 2015 and Pearson Correlation Coefficients (r) were calculated to determine the relationship between LMC and NHIR. RESULTS There were more insured respondents in the Post ACA group compared to Group A, Group B, and Group C (82.3% vs. 78.2% vs. 76.5% vs. 77.1%). There was a statistically significant relationship between time and males (r2 =0.987, p=0.006) and females (r2 =0.916, p=0.04) reporting Tier 3 LMC. In females, there was an inverse relationship between time and reported Tier 2 (r2 =0.976, p=0.01) as well as Tier 4 (r2 =0.962, p=0.02) LMC. There was a significant correlation between NHIR and female reported Tier 1 LMC (r=0.998, p=0.04). NHIR was not associated with Tier 2,3,4, 5 as reported LMC. CONCLUSIONS This is the first study to assess both male and female contraception in the era of ACA. Our results suggest that female use of Tier 1 contraception has become significantly more prevalent with higher NHIR. Interestingly, coverage of these methods is not always required under the ACA. In addition, we found that utilization of Tier 3 contraceptives significantly increased, while Tier 2 and Tier 4 significantly decreased over the study time interval. These changes were not associated with NHIR. This study is limited by the nature of the CDC's NSFG dataset, and follow up analysis will clarify the ongoing implications of the ACAM on contraceptive use. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e687 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Anuj S. Desai More articles by this author Alicia Roston More articles by this author James Wren More articles by this author Mary Kate Keeter More articles by this author Mehul S. Patel More articles by this author Matthew T. Hudnall More articles by this author Minh N. Pham More articles by this author Lauren F. Cooley More articles by this author Nelson E. Bennett More articles by this author Robert E. Brannigan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...