Direct Access to OB-GYN
The Report Card examines state policies that provide direct access to reproductive and related health care without having to obtain a referral. This is particularly an issue for female enrollees if they do not select an OB/GYN as their primary care provider.
Health plans must allow women to have direct access to obstetric and gynecologic (OB/GYN) care providers, meaning they will not need a referral to access basic reproductive health care; this provision took effect in September 2010. "grandfathered" plans--those that existed before the Affordable Care Act was passed--are exempt from this requirement, but plans will lose their grandfathered status if they significantly cut benefits, increase out-of-pocket spending, or change insurance carriers.
Does the state require that managed care programs allow women to have direct access to broad reproductive, gynecologic and health maintenance services?
States receive a "meets policy" if they have such provisions, and a "no policy" if they do not.
State requirements apply to managed care organizations and to the large group market (50+ employees) only.
| State | Strength of Policy | Change from 2007 |
|---|---|---|
| Alabama | Meets Policy | Same |
| Alaska | No Policy | Same |
| Arizona | No Policy | Same |
| Arkansas | Meets Policy | Same |
| California | Meets Policy | Same |
| Colorado | Meets Policy | Same |
| Connecticut | Meets Policy | Same |
| Delaware | Meets Policy | Same |
| District of Columbia | Meets Policy | Same |
| Florida | Meets Policy | Same |
| Georgia | Meets Policy | Same |
| Hawaii | No Policy | Same |
| Idaho | Meets Policy | Same |
| Illinois | Meets Policy | Same |
| Indiana | No Policy | Same |
| Iowa | No Policy | Same |
| Kansas | Meets Policy | Same |
| Kentucky | Meets Policy | Same |
| Louisiana | Meets Policy | Same |
| Maine | Meets Policy | Same |
| Maryland | Meets Policy | Same |
| Massachusetts | Meets Policy | Same |
| Michigan | Meets Policy | Same |
| Minnesota | Meets Policy | Same |
| Mississippi | Meets Policy | Same |
| Missouri | Meets Policy | Same |
| Montana | Meets Policy | Same |
| Nebraska | No Policy | Same |
| Nevada | Meets Policy | Same |
| New Hampshire | Meets Policy | Same |
| New Jersey | No Policy | Same |
| New Mexico | Meets Policy | Same |
| New York | Meets Policy | Same |
| North Carolina | Meets Policy | Same |
| North Dakota | No Policy | Same |
| Ohio | Meets Policy | Same |
| Oklahoma | No Policy | Same |
| Oregon | Meets Policy | Same |
| Pennsylvania | Meets Policy | Same |
| Rhode Island | Meets Policy | Same |
| South Carolina | Meets Policy | Same |
| South Dakota | No Policy | Same |
| Tennessee 1 | No Policy | Same |
| Texas | Meets Policy | Same |
| Utah | Meets Policy | Same |
| Vermont | Meets Policy | Same |
| Virginia | Meets Policy | Same |
| Washington | Meets Policy | Same |
| West Virginia | Meets Policy | Same |
| Wisconsin | Meets Policy | Same |
| Wyoming | No Policy | Same |
Data Sources: 1) The Henry J. Kaiser Family Foundation, “State Mandated Benefits: Direct Access to OB/GYNs,” 2008, available at http://www.statehealthfacts.org/comparetable.jsp?ind=493&cat=7&sub=114&y..., accessed September 8, 2010; 2) National Women's Law Center, unpublished data, collected July 2010.
Footnotes
1 Tennessee was graded incorrectly in the 2007 Report Card. It should have received a "no policy" instead of a "meets policy." Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data, that is, there is no change from 2007.
