Consistency of Health Insurance Coverage and Women’s Reproductive Healthcare Access During Early Adulthood

Women’s reproductive healthcare access is crucial in preventing unplanned pregnancies, sexually transmitted infections, and certain cancers. Adult women covered by health insurance are significantly more likely to access reproductive healthcare services than those without insurance, but limited research has focused on access among youth adult women or to how changes in insurance coverage shape healthcare access. The present study extends this research by examining differences in access to gynecological exams and prescription contraceptives between young adulthood women who, during the past year, were either always insured, never insured, or only sometimes insured (for 1–11 months). We do so with data from a nationally representative sample of young adult women in Waves III (2001–2002, ages 18–26) and IV (2008–2009, ages 24–32) of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Results from multivariable logistic regression models indicate that young adult women who were always uninsured or only sometimes insured are significantly less likely than always insured women to have had a gynecological exam in the past year or to use prescription contraceptives. In addition, we find no evidence that increases in the number of months insured is associated with these outcomes among women who were only sometimes insured during the past year. These findings suggest that marginal increases in monthly insurance coverage rates will be of limited benefit to women seeking these key reproductive healthcare services, and that moving women to complete coverage is associated with the highest rate of healthcare access.