Privately Insured Women's Expectations of Contraceptive Access without the Affordable Care Act and the Influence of State Contraceptive Equity Protections

Under the Affordable Care Act's (ACA) contraceptive coverage mandate, privately insured women can obtain contraception without cost sharing—a provision that the federal government is attempting to roll back. If this occurs, some states' contraceptive equity laws will continue to guarantee no-cost contraception. Analyzing national survey data, we investigate whether residence in a state with contraceptive equity protections is associated with expectations for contraceptive access if ACA is repealed among privately insured women. Women in states with and without contraceptive equity protections had similar expectations regarding contraceptive access without ACA. Women who identified as or leaned Democrat and users of long-acting reversible and other hormonal contraceptive methods were more likely to be concerned about access to a preferred contraceptive method and expect a cost increase. These findings reflect a potential lack of knowledge of state protections and diffuse concern about contraceptive access, indicating the need for both increased public policy education and stronger protections.