Medicaid Payment For Postpartum Long-Acting Reversible Contraception Prompts More Equitable Use

Area of Science:

• Public Health
• Health Policy
• Reproductive Health

Background:

• Access to effective contraception is crucial for reproductive autonomy.
• State Medicaid programs are increasingly covering immediate postpartum long-acting reversible contraception (LARC).
• Understanding the impact of these policies on LARC uptake is essential.

Purpose of the Study:

• To evaluate the effect of state Medicaid policies on immediate postpartum LARC use.
• To examine disparities in postpartum LARC uptake by race and ethnicity.

Main Methods:

• Utilized quasi-experimental difference-in-differences design.
• Analyzed Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012-2018.
• Compared LARC use in states with and without immediate postpartum LARC payment policies.

Main Results:

• The policy led to a 2.1-percentage-point increase in overall postpartum LARC use.
• No significant change in LARC use was observed among White mothers.
• A 3.7-percentage-point increase in LARC use was observed among Black mothers compared to White mothers.

Conclusions:

• Medicaid policies for immediate postpartum LARC show a positive impact on uptake, particularly for Black mothers.
• Further research is needed to ensure these increases align with patient preferences and promote equitable, patient-centered care.