Key Points

  • Over the past 15 years, 22 states have sought and received federal approval to extend Medicaid coverage for family planning services to residents solely on the basis of income under a complicated process known as a “waiver.”
  • A ground-breaking provision included in the March 2010 health care reform law greatly simplifies the process for a state seeking to expand Medicaid eligibility for family planning and allows for coverage of a larger population than currently included in any existing waiver program.
  • This report provides a tool to help gauge the potential impact in each state of taking up this new authority.
  • Twenty-eight states do not currently have an income-based family planning expansion. Nineteen states without an expansion could each serve at least 10,000 individuals, avert at least 1,500 unintended pregnancies and save at least $2.3 million in state funds in a single year, by expanding Medicaid eligibility under the new authority. Nine of these 19 states could each serve at least 50,000 individuals, avert at least 7,500 unintended pregnancies and save at least $17.4 million in state funds in a single year.
  • Among the 22 states that already have a family planning expansion in place via the older waiver process, 11 could each serve at least 10,000 individuals, avert at least 1,300 unintended pregnancies and save at least $1.7 million in state funds in a single year, in addition to what their expansions achieve today.