States play a central role in supporting access to contraceptive care through the administration of state Medicaid and public health programs, as well as through regulation of public (Medicaid and Children’s Health Insurance Program) and private health insurance. Many states are advancing innovative policies and programs to strengthen access to contraceptive care in a shifting landscape, influenced by factors such as primary and maternity care workforce shortages, long travel distances to contraceptive care providers, and financing constraints for public health clinics providing family planning services.
To learn more about the health and economic benefits of contraception and state Medicaid strategies to provide access to contraceptive care, visit NASHP’s explainer.
What is the role of state policy in supporting access to contraceptive care?
Medicaid Coverage for Family Planning Services: State Medicaid programs provide contraceptive care to millions of people every year, with Medicaid covering nearly 83 million people and approximately two-thirds of adult women enrolled in Medicaid being of reproductive age. State Medicaid programs provide coverage for family planning services, including prescription contraceptives, health education, testing and treatment for sexually transmitted infections, and preconception services such as screening for smoking or mental health needs. A majority of states have also expanded eligibility for coverage of family planning services through Medicaid for individuals not eligible for full Medicaid coverage, increasing the number of people who have access to these services.
Title X Family Planning Programs: The Title X Family Planning Program, a federal grant program often administered by state public health departments, serves approximately 2.6 million clients annually, providing comprehensive reproductive health and preventive care services at no or low-cost for eligible individuals.
State Requirements for Coverage of Contraception: States can establish coverage requirements for public and private insurers, such as state requirements for the coverage of prescription contraceptives by state-regulated health plans, coverage of an extended supply of contraception, and coverage of over-the-counter contraceptives without a prescription.
Licensing and Regulation of the Health Care Workforce: States establish and oversee the credentialing and licensing of the health care workforce including training and education requirements, as well as authorities to provide contraceptive services and prescribe contraceptives.
Through work with state officials in Medicaid and public health programs and other agencies, NASHP has identified six state priority areas for strengthening access to contraceptive care:
- Supporting the health care workforce to expand access to contraceptive care
- Following best practices in pharmacist prescribing of contraceptives
- Expanding coverage of contraceptive care in state Medicaid programs, including under family planning benefits
- Braiding funds to increase access to quality contraceptive care for the uninsured and those who experience barriers to accessing care through insurance
- Establishing state contraceptive coverage requirements
- Improving contraceptive care access through extended supply policies
States are innovating across these priority areas to strengthen coverage for contraceptive care, address financial and logistical barriers to accessing contraception, support new models for delivering contraception, and develop and support the health care workforce to strengthen access to contraceptive care. Many states are prioritizing access to contraceptive care as part of broader work to support women’s health, elevating strategies to support timely and comprehensive contraceptive counseling and access to the full range of contraceptive methods.
This work is made possible through generous support from Arnold Ventures.
