There was a “significant increase” in the number of women getting intrauterine devices, known as IUDs, and other forms of long-acting contraceptive methods in the month after President Donald Trump was elected, a new study found.
The research confirms media stories from the months after Trump’s election which reported that women were flocking to doctors in increased numbers and asking for intrauterine devices and other forms of long-acting reversible contraception amid worries that Trump’s promise to repeal former President Barack Obama’s health care law would limit access to birth control. Several LARC methods are effective long enough to outlast a four-year presidency.
The study, published in the journal JAMA Internal Medicine on Monday, found a “significant increase in LARC insertions” among commercially insured women in the 30 days after the 2016 presidential election, compared to the 30 days before the election. Researchers compared the data to the same time period in 2015 to adjust for seasonal trends, and also adjusted for patient characteristics. The increase corresponds to approximately 700 additional insertions per day in the U.S., the researchers estimated.
LARC methods include IUDs as well as implants typically inserted into the upper arm. They can last anywhere from three to 12 years, depending on the type.
“Our findings could reflect a response to fears of losing contraceptive coverage because of President Trump’s opposition to the [Affordable Care Act] or an association of the 2016 election with reproductive intentions or LARC awareness,” researchers wrote in the paper.
Under the Affordable Care Act, insurers in the health insurance marketplace were required to provide coverage for all types of FDA-approved birth control without copays. During the election, Trump repeatedly said he would repeal the health care law.
The Trump administration has also sought to make it easier for employers to claim exemptions from the contraceptive mandates on religious or moral grounds. In October 2017, the administration issued two interim rules rolling back the mandate for employers seeking exemptions. In Nov. 2018, the administration released final rules on the exemptions that would make it easier for employers to deny insurance coverage for birth control. The rules were blocked by a district court judge in January.
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In 2016, the daily LARC insertion rate was 13.4 per 100,000 women in the 30 days before and including the election on Nov. 8. In the 30 days after the election, the rate was 16.3. The gap was larger than during the same time period in 2015.
The researchers used the IBM/Truven MarketScan Analytics Commercial Claims and Encounters Database and billing rates to study women aged 18 to 45 enrolled in commercial insurance.
Researchers acknowledged the study had limitations: they lacked information about race and ethnicity, and the study was limited to those women with commercial insurance. The study also looked only at the 30 days before and after the election, and the authors were not able to determine if the increase in LARC insertions was sustained. Data from 2017 was not available.