Contraceptive Use Among Medicaid-Covered Teens and Risk of Teen Conception: A Longitudinal Study

Abstract

Objective:

To investigate Medicaid-covered teens' receipt of physician-prescribed contraceptives and the impact of this receipt on pregnancy rates before and after welfare reform and the expansion of children's public health insurance in the late 1990s.

Methods:

Contraceptive prescriptions and pregnancy events were identified from Medicaid claims for two 24-month periods (January 1, 1994–December 31, 1995, and January 1, 2000–December 31, 2001). Participants were all female Medicaid beneficiaries aged 15–19 enrolled anytime in the two 24-month periods, excluding teens pregnant within the first 3 months of enrollment, with incomplete enrollment data or undocumented immigration status, enrolled in a capitated Medicaid plan, or with other concurrent health coverage. We used a discrete-time hazard model to examine the association between paid contraceptive prescriptions and other variables and conception in Florida and Georgia.

Results:

Receipt of physician-prescribed contraceptives increased from 11% to 18% among Florida teens and from 22% to 27% among Georgia teens during the study period. Georgia teens receiving contraceptive prescriptions were 45% less likely to conceive than teens with no contraceptive prescriptions in 1994–1995 and 64% less likely in 2000–2001. In Florida, teens receiving contraceptive prescriptions were one third less likely to conceive than teens with no contraceptive prescriptions in both 1994–1995 and 2000–2001.

Conclusions:

An increase in the receipt of contraceptive prescriptions paid by Medicaid may help in reducing pregnancies among low-income teens.