Health Reform Law Eases Way for States To Quickly Expand Access to Medicaid Family Planning Services

January 25, 2011 — A provision in the federal reform law (PL 111-148) aims to make it easier and faster for states to expand Medicaid coverage for family planning services and contraceptives, Politico reports.

In the past, the federal government required states seeking to extend Medicaid coverage for family planning services to lower-income residents with incomes too high to qualify Medicaid to go through a “laborious” application and approval process. Prior to the health reform law, states applying to offer the expanded access could wait up to two years to receive approval from CMS, according to a new report by the Guttmacher Institute. In addition, states needed to reapply every few years for a waiver to provide the services. As of Nov. 22, 2010, 22 states have received federal approval to expand eligibility for Medicaid family planning services based on income, according to the Guttmacher Institute report.

The health reform law allows for a streamlined process that takes only a few months. States wishing to expand eligibility for Medicaid family planning services can seek federal approval through a more efficient state Medicaid plan amendment process. Once CMS approves a state plan amendment, the changes become part of the state's Medicaid program and states do not have to reapply to continue offering expanded access to Medicaid family planning services. CMS will continue to reimburse states at a 90% matching rate for approved family planning services.

Over the summer, Cindy Mann, CMS director of Medicaid and State Operations, said that officials made it easier for states to expand eligibility for family planning services under the reform law because "the provision of such services has been found to be cost effective for the Medicaid program."

In August 2010, CMS made applications available for the streamlined application process. So far, California, South Carolina and Wisconsin have submitted Medicaid state plan amendments (Kliff, Politico, 1/24).