State laws mandate insurers cover a 12-month supply of contraception but this requirement is rarely followed by insurers, a JAMA Health Forum study reviewing Medicaid plans in nearly a dozen states found.
The analysis revealed there has been no significant increase in year-long prescription orders for birth control pills.
Studies show that continued access to birth control pills, so women don’t have to return to the pharmacy every one to three months, results in decreased rates of unintended pregnancy. In many states, Medicaid allows beneficiaries to obtain 12 months of contraception at once.
“After the policy passed, we just saw a pretty small increase, just a couple of percentage points, in terms of people getting a 12-month supply, suggesting that the states’ policy, which is state law in 19 states, is not being fully implemented,” said Maria Rodriguez, director of the Oregon Health & Science University Center for Reproductive Health Equity, in an interview with Fierce Healthcare.
Beneficiaries received a 12-month supply just 4.39% more often. The policy was most successful in California, where there was a 7.17% increase, but other states saw an uptick of less than 1%.
She added it’s common for private insurers to reject the policy as well.
Rodriguez advocates for two changes to get insurers covering contraception as they are required. First, hospitals and health systems should set their default prescriptions for a 12-month supply in electronic health records, as pharmacists need to dispense the fully allotted supply.
Second, she wants a federal mandate for 12-month coverage.
“If it's a requirement at the federal level, then insurers no longer have the argument of [saying] ‘I’m not only an Oregon-based insurance company’ or ‘I’m not only based in this state.' They’ll still be required to follow the law,” Rodriguez explained.
The study analyzed 4.78 million Medicaid enrollees. The states examined were Vermont, California, Hawaii, New York, Nevada, Delaware, Massachusetts, Maryland, New Hampshire and New Mexico, as well as the District of Columbia.