Illinois is among the first states to enact policies intended to improve affordable access to over-the-counter (OTC) daily oral contraception. People with Medicaid insurance and commercial insurance governed by state law should be able to use their insurance to obtain OTC contraception without cost-sharing or co-pays. How well these polies are being implemented and successfully utilized is not well known; preliminary sales and claims data suggests a significant gap between demand for OTC contraception in Illinois and use of insurance coverage. Our study aims to explore the current barriers and facilitators to implementation of Illinois policies supporting insurance coverage for OTC contraception.

We pose three research questions: 1) are Illinois residents aware that OTC daily oral contraception may be covered by their insurance?; 2) do Illinois pharmacies have a process for billing insurance for OTC contraception?; and 3) are insurance plans complying with state law requirements? We will use three methods to answer these questions: A) focus groups with individuals capable of pregnancy with interest in using oral contraception who have insurance; B) interviews with key informants who have experience and perspective on the implementation of state OTC contraception coverage policies; and C) an in-person pharmacy survey to explore availability of OTC contraception insurance coverage. We will leverage expertise from an Advisory Team to guide study design, recruitment, implementation, and dissemination and partner with a community organization to facilitate focus groups. Lessons learned can inform improved policy implementation in Illinois and best practices for other states considering similar policies.