Maternal and Child Health Journal

, Volume 23, Issue 5, pp 657–666 | Cite as

Prescription Contraceptive Sales Following the Affordable Care Act

  • Lindsey Rose BullingerEmail author
  • Kosali Simon


Objectives We examine trends in prescription contraceptive sales following the Affordable Care Act’s (ACA) zero-copayment contraceptive coverage mandate in areas more likely to be affected by the provision relative to areas less likely to be affected. Methods Before the ACA, several states had their own contraceptive insurance coverage mandates. Using a national prescription claims database combined with wholesaler institutional sales activity from January 2008 through June 2014, we compare sales of the intrauterine device (IUD), implant, injectable, pill, ring, and patch in states that had a state-level insurance coverage mandate before the ACA to states that did not. Results Overall, our results imply the ACA increased sales of prescription contraceptives, with stronger effects for some methods than others. Specifically, we find the ACA increased sales of injectable contraceptives, but had no significant impact on sales of the IUD, implant, pill, or patch in states without a state-level mandate before the ACA relative to states that had a state-level mandate. We also find suggestive evidence of a reduction in sales of the ring. Conclusions for Practice Demand responses to changes in out-of-pocket expenses for contraception vary across methods. Eliminating copays could promote the use of contraceptives, but is not the only approach to increasing contraceptive utilization.


Prescription contraceptives Affordable Care Act LARC methods 


Compliance with Ethical Standards

Conflict of interest

No conflicts of interest.

Supplementary material

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Supplementary material 1 (DOCX 92 KB)
10995_2018_2680_MOESM2_ESM.docx (14 kb)
Supplementary material 2 (DOCX 13 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Public PolicyGeorgia TechAtlantaUSA
  2. 2.School of Public and Environmental AffairsIndiana UniversityBloomingtonUSA

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