UC Sociologist Publishes on Health Insurance, Contraceptive Access

Danielle Bessett, assistant professor of McMicken’s Department of Sociology, recently published her post-doctoral research findings in a Women’s Health Issue’s article. Bessett’s piece titled “Barriers to Contraceptive Access after Health Care Reform: Experiences of Young Adults in Massachusetts” was named Editor’s Choice and will be available free of charge. 

Bessett and her colleagues decided to conduct this fieldwork in Massachusetts because the state was a model for the 2010 Patient Protection and Affordable Care Act, ACA. Additionally, the high-uninsured rates of young adults aged 18 to 26, were an explicit target of the reforms, so they wondered how this group would be affected. Bessett believed sexual and reproductive health care, SRH, was the best place to start examining the effects of the reforms because SRH is often the most frequent contact many young adults have with medical insurance. 

The fieldwork for this research was completed when Bessett was an Ellertson Postdoctoral Fellow at Ibis Reproductive Health in Cambridge, Mass. The group conducted 11 focus group discussions across Massachusetts with 89 women and men aged 18 to 26 in 2009. While most of the focus groups were in English, two were conducted in Spanish. 

“With the implementation of the ACA, I saw that there was a need to broaden the audience of this study, which had previously been disseminated only in a report,” said Bessett. “The more awareness we can raise about these barriers, the better, since so much of the problems stem from ineffective messaging, a lack of information and misinformation.”

Bessett notes that Massachusetts is a best case scenario setting, because many people were insured before health care reform, residents are more likely to hold college and advanced degrees and have educational capital to navigate complicated health insurance rules, and there is a lot of support for the reforms and SRH care at all levels of state government. She says many of the problems identified in Massachusetts would be even more severe in other states that do not have these characteristics.

“It's particularly wonderful that this article was chosen as the Editor's Choice, not only because of the honor, but also because potential readers and policymakers across the country can access the article online for free,” Bessett said. 

Bessett and her colleagues found that of the 11 focus group discussions, many of the young adults involved were poorly informed about their options for both insurance plans and contraception. Because Massachusetts’ law was a model for the ACA, other young adults across the country are likely to encounter the same types of barriers that participants from Bessett’s Massachusetts study reported. 

The study found that many of the participants had trouble in comparing and securing a health insurance plan that are often tied to affiliation with an employer or school, which can be especially difficult for young adults whose lives are characterized by transitions. In many cases, Bessett found that uninsurance appeared to stem from ignorance of mechanisms that could help them to stay insured as their circumstances changed.  

Additionally, Bessett’s research found that overall health insurance literacy was low and that young adults often relied on their parents to make their health insurance choices. While some of the young adults discussed their SRH needs with their parents, others did not out of awkwardness. 

To view Bessett’s full article visit the Women’s Health Issues website: http://www.whijournal.com/article/S1049-3867(14)00131-5/fulltext