July 8, 2015 — A program designed to increase access to long-acting contraceptives in Colorado has had "startling" results, with the state's teen birth rate dropping by 40% between 2009 and 2013, the New York Times reports (Tavernise, New York Times, 7/5).
The Colorado Family Planning Initiative offers no- or low-cost LARCs, such as intrauterine devices and hormonal implants, to low-income women at 68 clinics throughout the state. The initiative was established as a five-year pilot program through a $25 million private donation.
In May, a Colorado Senate committee killed a measure (HB 15-1194) that would have provided $5 million in funding to continue the program. The private donation funding is slated to run out this year. However, Larry Wolk, Colorado's chief medical officer and executive director of the Colorado Department of Public Health and Environment, has pledged that the program will remain in place despite the funding concerns (Women's Health Policy Report, 6/2).
Program Linked To Improved LARC Use, Declining Pregnancy, Abortion Rates
According to the Times, around 20% of Colorado women ages 18 to 44 now use LARCs, with a significant increase in the number of teenagers and low-income women using such methods. By contrast, in the U.S. overall, about 7% of women ages 15 to 44 used LARCs between 2011 and 2013, up from 1.5% of women in 2002.
Further, in addition to the drop in the teenage birth rate, CDPHE found that the program was linked to a 42% decline in the abortion rate among teenagers in the state between 2009 and 2013. The number of births to unmarried women under age 25 who have not finished high school also declined over the five-year period, the Times reports.
The program's effects most notably were seen in the state's low-income areas, the Times reports. For example, 50% of all first births to women in the state's lowest-income areas in 2009 occurred before the women turned age 21. By contrast, in 2014, 50% of such first births did not occur until women had turned age 24.
According to advocates, that age difference allows young women time to complete their education and secure employment. Isabel Sawhill, an economist at the Brookings Institution, said, "If we want to reduce poverty, one of the simplest, fastest and cheapest things we could do would be to make sure that as few people as possible become parents before they actually want to."
Greta Klinger, who oversees CDPHE's family planning initiatives, said the program's effects are unlike anything state officials had ever seen before, noting, "The numbers were plummeting."
ACA Not a Guaranteed Fall-Back
Meanwhile, advocates have raised concern that if the program does expire, some women will not be able to access the contraceptives even though the Affordable Care Act (PL 111-148) mandates that all insurers cover most contraceptives without cost-sharing. According to the Times, some health plans only cover certain contraceptive methods and some grandfathered plans still require cost sharing.
Further, advocates also worry some teenagers will not use their health plans to obtain the contraceptives if they remain on their parents' coverage because of concerns about confidentiality. Without coverage, LARCs can cost between $800 and $900, according to the Times (New York Times, 7/5).