Background:
Over the past 15 years, 26 states have sought and received waivers from the federal Centers for Medicare and Medicaid services to expand eligibility for family planning services to individuals who otherwise would not be eligible for coverage under Medicaid. Nineteen of these states determine eligibility based solely on income, regardless of whether the individual meets any of the other categorical requirements for Medicaid coverage.

Objectives:
This presentation will provide an overview of the experience of these programs and the potential impact of an expansion of these programs to additional states. This presentation will discuss the structure of the programs, how they address key issues related to eligibility and enrollment and the documented impact seen in various states.

Methods:


Results:
The family planning programs have had a significant impact in expanding access to services. By providing family planning services to eligible individuals, these programs have enabled women to avoid both unintended pregnancies and the abortions that would follow, while generating significant cost savings for both the federal government and the states.

Conclusion and implications for practice:
The existing Medicaid family planning eligibility expansions can serve as useful models for possible expansions in other states. Moreover, the success of these programs supports efforts to make establishing and retaining them less cumbersome for states, such as attempts to allow states to institute programs by amending their state Medicaid plan rather than having to go through the cumbersome process of obtaining a federal waiver. Moreover, these programs provide models for extending Medicaid coverage for key reproductive health services to large groups of women prior to pregnancy.