Medicare, the primary insurer for 1.5 million reproductive-aged women with disabilities in the US, lacks mandated coverage for contraceptives, potentially limiting access and usage among this population, according to a recent national study.
Impact of Coverage Types on Contraceptive Use
The study analyzed over 51 million monthly observations from more than 1.6 million women aged 20 to 49 enrolled in various public insurance programs between 2016 and 2020. Findings revealed that traditional Medicare (TM) and Medicare Advantage (MA) enrollees reported the lowest contraceptive use, at 4.9% and 6.6% respectively, compared to dual-enrolled individuals and those solely on Medicaid. The demographic breakdown showed that 30.7% of observations were from Black women, 13.0% from Hispanic women, and 52.6% from White women, with TM and MA participants being generally older and predominantly non-Hispanic White.
Dual Enrollment Boosts Contraceptive Accessibility
Transitioning to dual enrollment with Medicaid was associated with a significant 35% increase in contraceptive use, especially among short-acting methods where usage rose by 45%. This suggests that adding Medicaid coverage alleviates financial barriers posed by Medicare’s limitations, enhancing access to a broader range of contraceptive options for disabled women.
• Medicare’s lack of mandated contraceptive coverage restricts access for disabled women.
• Dual enrollment with Medicaid substantially increases contraceptive usage.
• Racial disparities exist, with non-Hispanic White women more likely enrolled in higher-coverage plans.
• Short-acting contraceptives see the most significant increase with dual coverage.
Aligning Medicare’s policies with those of Medicaid and private insurers by mandating comprehensive contraceptive coverage could enhance reproductive autonomy for disabled women. Healthcare policymakers should consider these findings to improve insurance frameworks, ensuring equitable access to necessary contraceptive services.
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