In Reply Dr Becker correctly states that the degree to which insurance companies directly benefit from the ACA’s contraceptive coverage guarantee is a complicated matter warranting further investigation. Although data are not yet available to show whether eliminating out-of-pocket expense leads more women to use contraception, evidence from both public1,2 and private2,3 sectors suggests that the ACA’s guarantee should ultimately be cost saving. More importantly, any financial benefits to insurance companies are incidental and secondary to the public health goals of the ACA. The contraceptive coverage guarantee was designed to facilitate patient-centered choices about contraceptive methods that work for women, given their health needs and preferences.
Politi MC, Sonfield A, Madden T. Costs of Contraceptive Coverage Under the Affordable Care Act—Reply. JAMA. 2016;315(24):2735-2736. doi:10.1001/jama.2016.4763