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Medicaid Waiver

States can expand access to family planning services for low-income women, who often face additional barriers to care. While Medicaid is the largest public provider of family planning services for low-income women, four in 10 poor women of reproductive age still lack insurance coverage.1 States can expand access to these critical health services by taking up a state option that allows them to provide family planning services only under Medicaid to women, and sometimes men, who would otherwise be ineligible for the program.

States may, at their option, continue special Medicaid programs for family planning services. In fact, under the new "Medicaid Family Planning State Option,” states are allowed to adopt a Medicaid family planning expansion or improve their current program without a burdensome federal waiver process.

In addition, every woman with family incomes up to 133% of the Federal Poverty Level or FPL (that's about $14,440 for a single person or $29,000 for a family of four) will be eligible for the full Medicaid benefit package by 2014. Women in families earning between 133% and 400% of the Federal Poverty Level (that's between $14,404 and $43,320 per year for a single person) will be eligible for subsidies to help pay health insurance premiums and out-of-pockets costs starting in 2014.  These subsidies can be used for coverage purchased through new state-based "Health Insurance Exchanges."

Has the state implemented the option to expand Medicaid coverage for family planning services?

States can expand the pool of low-income women eligible for Medicaid coverage of family planning services by opting to broaden the state eligibility requirements for this service only. States that have implemented this option receive a "meets policy."  States that have not adopted a Medicaid family planning coverage expansion policy receive a "no policy."

State Strength of Policy Change from 2007
Alabama Meets Policy Same
Alaska No Policy Same
Arizona Meets Policy Same
Arkansas Meets Policy Same
California Meets Policy Same
Colorado 2 No Policy Same
Connecticut No Policy Same
Delaware Meets Policy Same
District of Columbia No Policy Same
Florida Meets Policy Same
Georgia 3 No Policy Same
Hawaii No Policy Same
Idaho No Policy Same
Illinois Meets Policy Same
Indiana 4 No Policy Same
Iowa Meets Policy Same
Kansas No Policy Same
Kentucky No Policy Same
Louisiana Meets Policy Same
Maine No Policy Same
Maryland Meets Policy Same
Massachusetts No Policy Same
Michigan Meets Policy Same
Minnesota Meets Policy Same
Mississippi Meets Policy Same
Missouri Meets Policy Same
Montana 5 No Policy Same
Nebraska No Policy Same
Nevada No Policy Same
New Hampshire No 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 No Policy Same
Oklahoma Meets 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 No Policy Same
Texas Meets Policy Same
Utah No Policy Same
Vermont No Policy Same
Virginia Meets Policy Same
Washington Meets Policy Same
West Virginia No Policy Same
Wisconsin Meets Policy Same
Wyoming Meets Policy Better

Policy Indicator Counts
Meets Policy: 
27
Limited Policy: 
0
Weak Policy: 
0
No/Harmful Policy: 
24
Better: 
1
Same: 
50
Worse: 
0

Data Source: Guttmacher Institute, "State Policies in Brief: State Medicaid Family Planning Eligibility Expansions," April 2010, available at http://www.guttmacher.org/statecenter/spibs/spib_SMFPE.pdf, accessed September 8, 2010.

Footnotes

1 Gold RB et. al., Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System (New York: Guttmacher Institute, 2009) available at http://www.guttmacher.org/pubs/NextSteps.pdf, accessed September 1, 2010.

2 Colorado has applied to the federal government, but has not yet received approval, for a waiver to implement a Medicaid family planning expansion.

3 Georgia has applied to the federal government, but has not yet received approval, for a waiver to implement a Medicaid family planning expansion.

4 Indiana has applied to the federal government, but has not yet received approval, for a waiver to implement a Medicaid family planning expansion.

5 Montana has applied to the federal government, but has not yet received approval, for a waiver to implement a Medicaid family planning expansion.

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