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MANAGED CARE August 2004. ©MediMedia USA













THE FORMULARY FILES

State mandates promote contraceptive coverage

A study involving 205 health care insurers conducted by the Alan Guttmacher Institute shows that employer-based health plans are considerably more likely to cover contraception than they were 10 years ago and that state laws mandating coverage have played a role in that growth.

In 1993, 28 percent of plans surveyed provided contraceptive coverage. In 2002 it was 86 percent.

Over the last six years, 21 states have mandated that private-sector insurers cover prescription contraceptives if they cover other prescription drugs. Understandably, in 2002, plans in states with mandates were more likely than states without mandates to cover a full range of contraceptives. In addition, national plans reported nearly universal coverage of reversible contraceptives. Adam Sonfield, a public policy associate at Guttmacher, points out that state mandates affected different types of plans. "The strongest effect might have been for PPO plans, which in 1993 had coverage almost as poor as indemnity plans."

SOURCE: ALAN GUTTMACHER INSTITUTE, 2002