Abstract
Unwanted pregnancies are a burden on women, their families, and government programs. Contraceptives reduce the incidence of unwanted pregnancies and abortions. Among the various methods of contraception, prescription contraceptives are the most effective at avoiding pregnancy. This raises the public policy question of whether a requirement for insurance companies to cover prescription contraceptives would prompt people to use them more. Fortunately, it is possible to use quantitative analysis to address the above question. Prior to the implementation of the Affordable Care Act, which mandates insurance companies to cover prescription contraceptives without an out-of-pocket cost for the consumer, some states had mandates for insurance companies to cover prescription contraceptives. I hypothesized that living in a state that mandates insurance companies to provide such coverage increased the odds of using prescription contraception as opposed to using less effective methods, such as over the counter contraceptives, rhythm, or withdrawal when compared to states that do not mandate contraceptive coverage. I analyzed data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS) and included fertile women from 18 to 44 years old who engaged in sexual activity with males and used contraception. I compared a state that had a mandate (Arizona) with two states without a mandate (South Carolina and Tennessee). I used various statistical methods, including propensity score matching, and found that living in a state that had a mandate had a statistically insignificant relationship with the use of prescription contraceptives, a result that does not support my hypothesis. I identified two possible explanations for this surprising finding, the particular states that participated in the BRFSS and the way that insurance companies set insurance policies. Further research is needed, including identification of methods to incentivize the use of effective contraceptives.