Affordable Care Act achieves birth-control savings

A provision of the Affordable Care Act that was designed to lower the cost of birth control seems to be working.

The health law requires insurance plans to cover prescription birth control without asking consumers to share in the cost. That means no need for a co-payment or to spend part of a deductible.

Health researcher Nora Becker says the goal is to nudge women toward preventive care that could save the health system money in the future.

“Contraceptives, when you are looking at them from a perspective that they are a preventive service, provide cost savings on the order of childhood vaccinations,” said Becker, who is in training to become a physician and also earning a doctorate at the University of Pennsylvania.

“Pregnancies are very expensive, childbirths are very expensive, so unless you are a women who’s actively seeking to become pregnant and have a child, an unplanned pregnancy is a very costly event for both you and the medical system,” she said.

Becker and colleagues reviewed claims for nearly 800,000 women with private insurance coverage. They studied data for six months before, then after the mandate was implemented.

They estimate that, after the mandate, women using the pill or an intrauterine device save about $250 a year on out-of-pocket costs.

“These are young healthy women, they don’t tend to have a lot of medical programs, but for them their birth control was a significant portion of their total out-of-pocket spending,” Becker said.

Before the mandate, women taking the pill were spending about $1,000 total out-of-pocket, with 30 to 45 percent devoted to birth control, the study found.

Dayle Steinberg, president of Planned Parenthood Southeastern Pennsylvania, was glad to see the study document what women’s health advocates know.

“Removing barriers saves women money,” she said.

The early rollout of the mandate was rocky in 2012.

“It took a while, not all providers were informed, not all consumers knew about it,” Steinberg said.

Even this year, there have been questions. Some health insurance companies were trying to deny “free” contraception for certain methods of prescription birth control, Steinberg said.

In May, the Obama administration issued a clarification. Health plans must offer consumers a “no cost” option for every type of prescription birth control approved by the the Food and Drug Administation.

With personal spending on contraception dropping quickly after the mandate, Becker said investigators are curious how the law will influence overall birth control use.

Becker said more women may switch to longer-term contraception methods — but for now that’s a guess.

“That’s what my next paper will be about, hopefully,” Becker said.