Association for Public Policy Analysis & Management

Family planning contraceptive benefits are considered a mandatory Medicaid benefit and states have significant flexibility in expanding access to individuals who are not otherwise eligible for traditional Medicaid through 1115 Waivers or State Plan Amendments. In 2018, 17 states had both an ACA expansion plan and a family planning waiver or State Plan, 11 states had only Family Planning waiver (with varying levels of coverage), the remaining states are without either. We use the Behavioral Risk Factor Surveillance System and Pregnancy Risk Assessment Monitoring Surveillance System to examine differential effects of family planning waivers and traditional Medicaid expansion on contraception access, utilization, unintended pregnancy, and birth outcomes. Using a difference in difference analysis we compare select states without family Medicaid expansion those with traditional Medicaid programs (<138%FPL), and those with family planning waivers (>138%). Results of the analysis will present percentage point changes of contraceptive need, unwanted and mistimed and unintended births between the pre-and post-policy implementation. Changes in level of family planning coverage through Medicaid and other public policy may lead to differential outcomes in states, these findings can be used to provide information to CMS and state Medicaid programs to improve outcomes through policy.