During the 2016 presidential election, then-candidate Donald Trump, along with the Republican Party at large, threatened the existence of the Affordable Care Act. Along with those threats came growing uncertainty over the future of contraceptive accessibility.

It is safe to say that women were concerned. So concerned, in fact, that many quickly made appointments to secure long-acting reversible contraceptives (LARCs).

After Election Day, reports claimed that there was an increase in women receiving LARCs. However, new research published in the JAMA Internal Medicine took the analysis a step further.

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Researchers set out to compare LARC insertion rates in the month before and the month after the 2016 election vs during the same time frame in 2015.

Lydia E. Pace, MD, MPH, from the Division of Women’s Health at Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues found that the days after the election saw a significant increase in women receiving LARC insertions. In the 30 days before the election, 13.4 per 100,000 women received insertions, but after the election, that went up to 16.3 per 100,000 women, an increase of nearly 22%.

Back in 2012, when the Affordable Care Act brought down the cost of LARC to $0, insertions went up. However, they are still underused across the United States today.

“Our findings could reflect a response to fears of losing contraceptive coverage because of President Trump’s opposition to the [Affordable Care Act],” wrote Dr Pace and colleagues. “Our findings also suggest that women with commercial health insurance value contraceptive coverage and that concerns about potential reductions in access or coverage may affect their contraceptive choices.”

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Although these data only include women with commercial insurance, it is an illuminating step showing that many women appreciate the importance of the accessibility of LARCs and other contraceptive options.


Pace LE, Dusetzina SB, Murray Horwitz ME, Keating NL. Utilization of long-acting reversible contraceptives in the United States after vs before the 2016 US Presidential election [published online February 4, 2019]. JAMA Intern Med. doi: 10.1001/jamainternmed.2018.7111