Q & A: The New Family Planning State Plan Option Under the ACA
Q. What is the new Family Planning State Option under the Patient Protection and Affordable Care Act (ACA)? (ACA is the new health reform law.)
A. The Family Planning State Option is a new way for States to expand access to family planning services and supplies by electing to cover a new optional eligibility category in Medicaid for individuals who need family planning services, but whose incomes are too
high or they don?t meet some of the other eligibility criteria for full-scope Medicaid.
In 1976, eleven years after the establishment of the Medicaid program, Congress amended the Medicaid Act to make family planning a mandatory service. Congress also established a special high 90% matching rate for family planning services to ensure state would have an incentive to provide the services and created protections against barriers like cost-sharing to ensure the services are accessible to individuals. Congress did all of this because family planning is an essential service for the health and independence of women and families, and also because there is overwhelming documented evidence that investment in coverage for family planning services produces incredible health care spending savings. By increasing access to family planning services through the establishment of a State Plan Option for family planning services, the federal government has further demonstrated its commitment to the importance of family planning as an essential health service and a prudent investment of scarce public health care dollars.
For advocates, the significance of the new State Plan Option is that it creates a new path for expanding access to family planning services, and may provide significant advantages over the waiver program alternative that previously existed. Increasing access to family planning services promotes public health equity because low income men and women will be more able to implement their decisions about when and whether to become parents and to reduce their risk of contracting sexually transmitted infections. Better family planning service options leads to better overall health care outcomes and potentially improves women?s educational and economic opportunities. Advocates are encouraged to press their states about the key health and economic benefits in expanding access to family planning services. At a time of great state fiscal uncertainty, expanding access to family planning services is a proven way to reduce health care spending.
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January 31, 2019
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