Why Colorado needs continued LARC funding regardless of the
Affordable Care Act
Colorado has invested substantially in the Affordable Care Act and should continue to have high expectations for the benefits, including significant investments in preventive health services that deliver health, social and financial returns. Attempts to provide long-acting reversible contraception for low-income women should be no exception.
Colorado has already seen some of these benefits in areas such as immunizations, cancer screenings and HIV/AIDS - all programs which were almost 100 percent government supported and have since transitioned to more than 50 percent covered by insurance.
To this point, LARC has not reached those same milestones and here are three reasons why:
- Insurance: Those with new insurance plans should be covered for LARCs and other contraceptives. However, a recent national survey indicates that 26% of people covered through employer plans have grandfathered plans, which may not yet cover contraception or limit access to the most effective methods, LARCs, because of high deductibles. As such, LARC still remains largely under-covered through increased deductibles and co-pays.
- Providers: Even if insurance covers it, many doctors are not trained to insert LARC. In addition, with each device costing an average of $900, most providers don't keep them in stock. Finally, insurance reimbursement is often lower than what the device costs and the physician reimbursement averages just $30. Colorado’s program ensures that doctors are trained, implants are on the shelves and providers are appropriately reimbursed.
- Patients: A number of teen and young adult women are still uninsured and underinsured. This is a transition issue including affordability of private coverage, life changes from school to work and aging out of their parent’s insurance which continue to be barriers to coverage at the time a young woman makes the decision to obtain LARC.
The Colorado Department of Health and Environment intentionally structured the bill with the understanding that the Affordable Care Act will continue to gain ground in providing the full range of contraceptive choices to women just as it has in other public health arenas. Additionally, the clinics providing this contraception are trained to help individuals enroll in and use health insurance. Clinic staffs are working to ensure that people with contraceptive coverage use it and use it correctly. That’s why the legislation includes a step down approach to funding over the next 5-6 years, beginning with $5 million each year and ultimately dropping to $2 million.
Analysis of the Colorado Family Planning Initiative’s current program users supports the idea that an end to funding at this juncture will likely cause an increase in unintended pregnancy, abortion and the social costs of increased families in poverty.