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State Prescription Contraception Insurance Mandates: Effects on Unintended Births
Author(s) -
Johnston Emily M.,
Adams E. Kathleen
Publication year - 2017
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12792
Subject(s) - unintended pregnancy , national survey of family growth , medical prescription , medicine , demography , family planning , population , actuarial science , business , environmental health , nursing , research methodology , sociology
Objective To test the effects of state prescription contraception insurance mandates on unintended, mistimed, and unwanted births in a sample of privately insured recent mothers. Data We pooled Pregnancy Risk Assessment Monitoring System ( PRAMS ) data from 1997 to 2012 to study 209,964 privately insured recent mothers in 24 states, 11 of which implemented prescription contraception coverage mandates between 2000 and 2008. Study Design Individual‐level difference‐in‐differences models compare the probability of unintended birth among privately insured recent mothers in state‐years with mandates to those in state‐years without mandates. Additional models use aggregate data to estimate the effect of mandates on states’ number of unintended births. Principal Findings State mandates are associated with decreased probability of unintended birth (1.58 percentage points) among privately insured women in the second year of implementation, driven by decreased probability of mistimed birth (1.37 percentage points or 614 births per state‐year) in the second year of implementation. We find no effects in the first year of implementation or on the probability of unwanted birth. Unexpectedly, recent mothers without private insurance experienced declines in unintended birth, but among unwanted, rather than mistimed, births. Conclusions State prescription contraception insurance mandates are associated with reduced probability of unintended and mistimed births among privately insured women.