Although Medicaid normally pays only for prescription medications, as of February 1, Medicaid recipients in New York State may obtain nonprescription Plan B emergency contraception directly from a pharmacy. With Governor Spitzer’s approval, New York becomes one of the few states to ensure that poor women are able to access this time-sensitive method under Medicaid without first having to visit a physician or clinic. Still, many women in New York and elsewhere do not know what emergency contraception is, when to use it or where to obtain it—facts that point to an ongoing need for public education. Also, women younger than 18 in all states still need a prescription to obtain Plan B, making it more difficult for them to access the method quickly and use it when it is most effective.

Initiatives such as New York’s to improve access to emergency contraception are just one way to help low-income women plan their families and prevent unwanted pregnancies: A recent Guttmacher study has shown that expanding Medicaid coverage for contraceptives to match similar coverage for pregnancy-related care would enable low-income women to prevent a total of nearly 500,000 unwanted pregnancies annually, including 200,000 that would end in abortion. By helping women to prevent an estimated 225,000 unwanted births, such an expansion would also save $1.5 billion in annual federal and state expenditures.

Overall, growing disparities between poor and higher-income women with regard to sexual and reproductive health care pose a serious challenge for policymakers. Poor women are twice as likely to lack health insurance, four times as likely to have an unintended pregnancy, five times as likely to have an unintended birth and more than three times as likely to have an abortion as their higher-income counterparts. Most unintended pregnancies could be prevented with consistent, correct use of modern contraceptives.

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Disparities in unintended pregnancy in the United States

The importance of publicly funded family planning for low-income women