Continuity of Health Insurance Coverage and Choice of Contraception Method

Area of Science:

• Reproductive Health
• Health Services Research
• Sociology of Health

Background:

• Access to prescription contraception is crucial for reproductive health.
• Insurance status significantly impacts healthcare utilization, including contraceptive method choice.
• Understanding the relationship between insurance gaps and contraceptive use is vital for public health policy.

Purpose of the Study:

• To investigate the association between part-year or year-round uninsurance and the likelihood of using prescription contraception methods.
• To compare the use of prescription methods versus nonprescription or no methods among women with different insurance coverage statuses.
• To inform policy interventions aimed at improving contraceptive access.

Main Methods:

• Analysis of data from the National Longitudinal Survey of Youth, 1997 cohort (2007-2019).
• Inclusion of nonpregnant, sexually active female respondents.
• Use of mixed-effects multinomial logistic regression to model contraceptive method choice based on insurance coverage (continuous private, continuous public, part-year uninsured, year-round uninsured).

Main Results:

• Part-year uninsurance was associated with a 20% reduced likelihood of using prescription methods over nonprescription methods compared to continuous private insurance.
• No significant difference was found in the likelihood of using prescription methods versus no method for part-year uninsured individuals.
• Year-round uninsurance was linked to the lowest use of prescription contraceptives.

Conclusions:

• Part-year uninsurance is associated with decreased use of prescription contraceptives compared to nonprescription methods.
• Continuous health insurance coverage, with flexible eligibility and enrollment, may enhance access to prescription contraceptives.
• Policy interventions should focus on ensuring consistent insurance coverage to support informed contraceptive choices.