Since the mid-1990s, many states have expanded eligibility for Medicaid coverage of family planning services. Historically, states have expanded their programs by securing approval of a "waiver" of federal policy from the Centers for Medicare and Medicaid Services. Most of the expansion states grant coverage for family planning solely on the basis of income to individuals not previously covered under Medicaid. A handful of states have received federal approval for more limited expansions that continue coverage for family planning for individuals who are leaving the Medicaid program. The passage of health care reform gave states a new and more expeditious option for expanding eligibility for family planning. Under this law, states may expand their programs by amending their state Medicaid plan. Unlike a waiver, which is time-limited, a State Plan Amendment is a permanent change to the state’s Medicaid program.
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- 26 states have federal approval to extend Medicaid eligibility for family planning services to individuals who would otherwise not be eligible. (Vermont operates a similar, but entirely state-funded program for the provision of family planning services. Iowa and Missouri also operate similar programs, but exclude abortion providers from their programs.)
- 24 states provide family planning benefits to individuals based on income; most states set the income ceiling at or near 200% of poverty.
- 4 states provide family planning benefits for women losing full-benefit Medicaid coverage, either when their postpartum period ends (3 states) or for any reason (1 state).
- 21 states provide family planning benefits to men and women.
- 21 states include individuals who are younger than 19 years of age; 1 additional state includes 18 year olds but not younger individuals.
- 17 states operate their programs through a State Plan Amendment; 9 states operate their programs under a waiver from the federal government.
- United States: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming