Medicaid family planning expansion programs have been shown to improve reproductive health outcomes and reduce unintended pregnancies. Connecticut implemented Medicaid Family Planning Expansion in March of 2012 with the intention of expanding access to family planning services and improving reproductive health outcomes. The aims of this study are to evaluate the effectiveness of the Medicaid Family Planning Expansion in reducing unintended pregnancies, estimate the funds saved to the state of Connecticut due to the expansion and to demonstrate that women will choose highly effective methods of contraception when cost is not a barrier.
Mathematical models developed by the Guttmacher Institute were adapted to estimate the number of pregnancies averted in the state based on patterns of contraceptive use in participants after enrolling in the program and contraceptive failure rates. The number of pregnancies averted was used to determine the state funds saved by reducing pregnancies that would have resulted in births covered by Medicaid. Multivariate logistic regression was used to examine predictors of using a highly effective method of contraception.
Complete data were available for 1,153 women enrolled in the Medicaid Family Planning Expansion program. Our calculations indicated that an estimated 84 unintended pregnancies were averted in this group between 2011 and 2013, with an estimated 31.2 unintended births averted and $324,379 saved to the state of Connecticut. Women enrolled in the expansion program were more likely to choose a highly effective method of contraception than women not enrolled (OR: 7.16, 95% CI: 5.76, 8.90).
Our results support the conclusion that when the barrier of cost is removed, women are more likely to choose highly effective methods of contraception, helping them to avoid unintended pregnancies. Our results suggest the need for continued funding of Medicaid Family Planning Expansion in Connecticut, and further research on barriers to enrollment in the program.
Yale School of Public Health
New Haven, CT
Angley, Meghan; Siddique, Moiuri; and Vasquez, Kimberly, "Examining the Effectiveness of Medicaid Family Planning Expansion in Connecticut" (2014). Practice Based Community Health Research Reports. 6.