The Affordable Care Act (ACA) increased access without cost to highly effective contraceptive methods, despite a legal challenge that was adjudicated by the Supreme Court, and it may help reduce unintended and teenage pregnancies.1 Unintended and teenage pregnancies are associated with delayed prenatal care, fetal exposures to tobacco and alcohol, and poorer health outcomes for newborns, as well as negative economic and social consequences for mothers and their children.2,3 Approximately 2.8 million unintended pregnancies occur in the United States each year, and, although teenage pregnancy rates have been declining for the last 2 decades, more than 430 000 pregnancies occurred among adolescents aged 15 to 19 years in the United States in 2011, including nearly 124 000 among adolescents aged 15 to 17 years.4 US teenage pregnancy rates are nearly 7 times higher than rates in some developed countries, and use of highly effective long-acting reversible contraception (LARC) remains low (<5%).3