Medicaid

Medicaid funding of family planning care is critical to ensuring access to high-quality, confidential family planning and sexual health services and supplies for poor and low-income individuals. Medicaid has been the predominant funding source (75%) for publicly funded family planning care since the 1980s, particularly in states that have expanded their Medicaid eligibility for family planning. Medicaid’s importance in providing publicly funded family planning care will continue to grow under the Affordable Care Act (ACA), as many states expand their Medicaid programs to Americans with incomes up to 138% of the federal poverty level (FPL).

Medicaid-funded family planning is proven to save taxpayer dollars by expanding access to contraception and increasing women’s use of more effective contraceptive methods - essential factors in reducing high rates of unintended pregnancy among low-income women. Federal law requires that Medicaid-funded family planning be exempt from cost-sharing requirements, such as deductibles and co-pays, and provides that most Medicaid managed care enrollees can receive family planning services from any provider (a provision referred to as "freedom of choice"), even if their provider of choice is outside of their managed care network.

NFPRHA's Work

NFPRHA works on federal policy and with its membership on state policy to expand access to and improve policies related to Medicaid-funded family planning.

Resources

NFPRHA Analysis

CMS Advancements in Medicaid Family Planning (PDF) – Analysis of new CMS regulations and sub-regulatory guidance that clarify and strengthen existing requirements governing the provision of family planning services and supplies under Medicaid (August 2016).

NFPRHA Fact Sheets

Medicaid: A Cornerstone of Publicly Funded Family Planning Care (PDF) - Fact sheet explaining the intersection of Medicaid and family planning (February 2017).
The Changing Face of Medicaid: Considerations and Next Steps for Family Planning Providers and Programs (PDF) - Analysis of key changes coming to Medicaid and how it might impact family planning providers (November 2013).

NFPRHA Letters

Letter to House of Representative Offices Opposing HR 3495, the Women's Public Health and Safety Act (PDF) – NFPRHA letter in opposition to a bill that would allow states to exclude abortion providers from Medicaid (September 2015)

	NFPRHA's Position
	NFPRHA believes that Medicaid funding of family planning and sexual health is critical to ensuring access to high-quality, confidential family planning and sexual health services and supplies for poor and low-income patients.

Happening Now

Thanks to the ACA, millions more have been determined eligible for Medicaid or CHIP programs since October 2013.
Medicaid enrollment is growing even in states not expanding Medicaid due in part to elevated outreach and enrollment efforts.
State and federal leaders continue to eye changes to Medicaid that could cut funding, waive important Medicaid benefits and protections, and undermine the program.
NFPRHA editorial on alternative forms of expansion appeared in Governing in February 2015.

NFPRHA Comments

NFPRHA Comments on CMS Medicaid Managed Care Proposed Rule (PDF) - NFPRHA comments on ensuring that confidentiality can be maintained in Medicaid Managed Care (July 2015).

Other Resources

Medicaid Alternative Benefit Plans: What States Should Consider When Designing Coverage for the Expansion Population and the Role for Advocates (PDF) - Families USA issue brief on what states and advocates should consider about alternative benefit plans when designing coverage for indivudals who receive care under the ACA's Medicaid expansion (November 2013).
Medicaid Expansion Through Premium Assistance: Arkansas, Iowa, and Pennsylvania's Proposals Compared (PDF) - Kaiser Family Foundation fact sheet comparing Medicaid premium assistance program proposals in several different states (December 2013).
The Growing State Cost of Not Expanding Medicaid (HTML) - Center on Budget and Policy Priorities information on the status of states that have not expanded Medicaid and associated costs (January 2014).
Advocate's Guide to MAGI (PDF) - National Health Law Program guide to the Modified Adjusted Gross Income (MAGI), the ACA-created methodology to evaluate eligibility for insurance programs (February 2014).

CMS Links

Informational Bulletin (PDF) - State Medicaid payment approaches to improving long-acting reversible contraception (LARC) access (April 8, 2016).
State Medicaid Director letter (PDF) - Clarifying Medicaid’s “free choice of provider” requirement in conjunction with state actions against Medicaid providers (April 19, 2016).
Final rule on managed care for Medicaid and the Children’s Health Insurance Program (CHIP) (PDF) - The rule, while broadly affecting family planning services and providers, includes specific policy enhancements and updates to program rules specific to family planning services and supplies (April 25, 2016).
State Health Officials letter (PDF) - Providing guidance on family planning services provided under both fee-for-service and managed care delivery systems (June 14, 2016).

For additional resources & information, access NFPRHA fact sheets and federal comments by issue or read NFPRHA's publications and recent press statements.

Medicaid

NFPRHA's Work

Resources

Happening Now

Issues

National Family Planning & Reproductive Health Association