Health Policy and Access to Long-Acting Reversible Contraceptives

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Center for Community Research & Service, Biden School of Public Policy and Administration, University of Delaware and School of Public Health, University of Maryland
Long-acting reversible contraceptives (LARCs), including intrauterine devices (IUDs) and contraceptive implants, are safe and effective methods for preventing unintended pregnancy. LARCs are 99% effective, they require little ongoing effort by patients, and they can be removed when a patient wishes. Both the American Academy of Pediatrics and the American College of Obstetrics and Gynecology recommend that LARCs be offered on a routine basis, to patients of reproductive age. Despite the advantages that LARCs offer to patients that desire them, they are also uniquely difficult to deliver in the U.S. health care system. The acquisition cost per unit for LARC devises is high relative to other methods and clinics may have difficulty keeping adequate stock on hand. Without payment mechanisms in place to adequately reimburse providers they may be prohibitively expensive to offer. LARC devices also require additional clinical training on appropriate counseling, placement, and removal. These factors, in addition to patient awareness, may create systemic barriers to offering LARC services at the clinic-level. To overcome these challenges, there has been efforts to adopt policies that will increase access to long-acting reversible contraceptives. This brief describes on-going state and federal efforts to increase LARC access, the background motivating this policy push, and potential unintended consequences to reproductive justice.
health policy, long-acting reversible contraceptives