• Description

Medicaid provides a critical source of health care coverage for low-income individuals in the United States, including 13 million women of reproductive age. Medicaid is also the primary source of family planning coverage, accounting for 75% of public expenditures for family planning services in the United States. State Medicaid programs have a long-standing requirement to provide family planning services in the benefits package that is provided to people enrolled in full-scope coverage. In order to expand the number of people who can access family planning services, states have also taken the option to establish Medicaid family planning programs that cover a suite of family planning services for individuals not otherwise eligible for full-scope Medicaid.

States have considerable flexibility in designing their Medicaid family planning programs. As a result, access to and utilization of Medicaid family planning programs are largely impacted by the policies and operational processes a state Medicaid program chooses to implement. The decisions a state makes related to its application process, consumer outreach, confidentiality policies, scope of covered benefits and provider network are all critical programmatic features that determine how easy or difficult it is for an individual to enroll in and receive services through Medicaid family planning programs.

To promote access and utilization, this issue brief provides an array of best practice strategies in place across the nation to serve as an actionable road map for states that might be considering adopting such a program as well as states with existing programs looking to bolster participation and utilization rates. The strategies are derived from a review of national literature and policies and practices across the country and informed by an analysis of participation rates and utilization of services in 22 of the 30 states with programs in place.