CMS Guidance on Family Planning State Plan Amendments

Rachel Benson Gold, Guttmacher Institute Rian Frachele, Oregon Public Health Division Robin Summers, National Family Planning & Reproductive Health Association
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First published online:

The Affordable Care Act (ACA) was signed into law on March 23, 2010.1 Sec. 2303 of that legislation allows states to amend their state Medicaid plans to expand eligibility for family planning services and supplies to individuals who are not pregnant and who have an income that does not exceed the income-eligibility level set by the state for coverage for pregnancy-related care (Appendix A). In the intervening months, the Centers for Medicare and Medicaid Services (CMS) has taken three sets of actions:

  • On July 2, CMS issued formal guidance to the states on the implementation of this provision (Appendix B);
  • On August 27, CMS circulated two draft preprints, one on the provision in general and one on covered services (Appendix C), for states to use to submit a state plan amendment (SPA); and
  • On August 31, CMS convened a conference call with state officials to discuss the  provision and provide additional guidance.

This memo summarizes the guidance CMS has provided to states, both in writing and verbally,
to date. As additional guidance is provided by CMS, we will update this memo with the goal of
maintaining a comprehensive description of CMS guidance on the family planning SPAs.