What happens when a state expands access to family planning services under Medicaid? This is the subject of a new report by the Guttmacher Institute. As the report points out, a provision of the 2010 health care reform legislation makes it possible for states to extend Medicaid sponsored family planning services to women and men who otherwise would not meet standard Medicaid eligibility requirements. There is good news in this story: states that have taken advantage of the new provision have reduced their number of unintended pregnancies, abortions, and Medicaid births, and have reduced their overall spending on health care services. As of November 2010, 22 states had already sought federal approval to extend Medicaid coverage of family planning services to residents on the basis of income only (Sonfield, Frost & Gold, 2011). In spite of having one of the highest low-birth weight and infant mortality rates in the nation, Tennessee has not taken advantage of the new provision (Annie E. Casey Foundation, 2010).
Potential Savings in Tennessee
According to the Guttmacher study, gains from the program extend to both families and the state. During the first year of implementation, the state could save close to a million dollars (Sonfield, Frost & Gold, 2011). The savings increase to over 20 million dollars during the second year. Statewide, 3,000 unintended pregnancies could be avoided, 1,000 abortions could be averted, and 400 Medicaid births could also be avoided (Sonfield, Frost & Gold, 2011).
The Guttmacher study suggests that when families have access to family planning services, families do better, rates of prenatal care rise, and newborns are likely to be healthier. The potential to expand Medicaid eligibility for family planning services would also respond to the high rate of teen pregnancy. Today, only 46% of babies born in Shelby County receive adequate prenatal care, and we have an infant mortality rate (IMR) of 12.3 per 1,000 births (Annie E. Casey Foundation, 2009). Expanding Medicaid access to family planning is a step toward decreasing these issues, and would be expected to save millions in Medicaid expenditures while also helping families make responsible decisions about parenthood.