Key Points

  • Since the mid-1990s, 22 states had implemented a program to extend Medicaid coverage for family planning services to residents on the basis of income, regardless of whether they meet other requirements for Medicaid coverage, such as being a low-income parent.
  • To reach out to new clients, state agencies have established program Web sites and telephone hotlines, linked up with other health and social services programs, and used tailored messages and tactics to reach young adults, Latinas and other groups in need.
  • To streamline enrollment, states have used tactics such as offering online applications, using databases to verify citizenship status and income, automatically enrolling certain groups of potential clients, and facilitating applications and enrollment at the point of service.
  • The expansion programs collectively serve about 2.7 million clients each year and have expanded the network of family planning providers and their capacity to meet the need for services.
  • The services provided have helped reduce levels of unprotected sex, increase use of more effective contraceptive methods and improve continuity of contraceptive use. They have also expanded access to related preventive care, such as screening for STIs and cervical cancer. 
  • Improved contraceptive use has translated into measurable declines in unintended and teen pregnancy and improvements in women’s ability to space their pregnancies. In the process, the expansions have substantially reduced federal and state Medicaid expenditures on unplanned pregnancy.
  • Taken collectively, the findings of state program evaluations and national analyses point to the undeniable value of publicly funded family planning services, both within state Medicaid programs and beyond. The programs’ innovations and best practices in outreach and enrollment hold important lessons for the implementation of U.S. health reform efforts.