Topic: Contraception
Access for Incarcerated People
These policies ensure that individuals who are incarcerated have access to the full range of contraceptive services, promoting bodily autonomy and continuity of care.
Emergency contraception
Emergency contraception (EC) policies can expand timely access to pregnancy prevention. Examples include laws requiring pharmacies, public higher education institutions, and hospitals to provide EC and ensure availability with no-cost coverage and without unnecessary delays.
Extended supply
Extended supply laws refer to policies that allow patients to obtain a 6- or 12-month supply of contraceptives at once, reducing gaps in use and access.
Foster/youth access
These policies ensure that young people in state custody—such as those who are in foster care—have access to the full range of contraceptive services, promoting bodily autonomy and continuity of care.
Hospital/ER requirements
These policies require hospitals and emergency rooms to provide contraception, particularly emergency contraception, to patients who need it under certain circumstances, including survivors of sexual assault.
Insurance coverage
Insurance coverage policies expand affordability by requiring public and/or private plans to cover contraception and related reproductive health services.
Medicaid ACA Expansion
States that chose to expand Medicaid under the Affordable Care Act extended coverage to more low-income individuals, which increased access to contraception and other health care services. This broader eligibility improves access to and continuity of preventive and reproductive health care.
Medicaid Family Planning Expansion
Medicaid family planning expansions allow states to cover contraception and related services for individuals who may not otherwise qualify for full Medicaid benefits. These programs typically include counseling, supplies, and preventive care at little or no cost and can be implemented through a Medicaid state plan amendment or 1115 waiver.
Medicaid Postpartum Extension
Medicaid for pregnancy-eligible individuals traditionally only covers six weeks of postpartum care. Extending Medicaid postpartum coverage to 12 months ensures access to a range of postpartum care to promote maternal health and provides continued access to contraception after pregnancy.
Minor consent
Minor consent laws allow adolescents to consent to their own contraceptive care, reducing barriers to timely and confidential care.
No cost-sharing
No cost-sharing policies eliminate out-of-pocket costs for contraceptive services, making them more accessible and affordable. States may prohibit co-pays, deductibles, or other charges for all FDA-approved methods.
Non-step therapy
Non-step therapy policies prohibit insurers from requiring patients to try and “fail” (meaning that they do not tolerate it well or it does not work effectively for them) one contraceptive method before they may receive coverage for another. These laws support patient-centered care and the medical expertise of providers and allow individuals to access the method that best meets their needs without unnecessary delays.
Nondiscrimination
Nondiscrimination protections ensure that individuals can access contraception regardless of gender, sexual orientation, gender identity, or other protected characteristics by prohibiting discrimination on those bases. These laws often apply to insurers, providers, and state-funded programs.
OTC coverage
Over-the-counter (OTC) coverage laws require insurers to provide coverage for contraceptives available without a prescription, overriding typical insurance coverage policies that do not cover over-the-counter medication. For example, states may mandate coverage of OTC birth control pills like Opill and some require coverage without a prescription or co-pay.
Pharmacist prescriber
These policies authorize pharmacists to prescribe and dispense contraceptives directly, without requiring a clinician visit, increasing access points for care. Many states allow pharmacists to furnish hormonal contraceptives following standardized protocols.
Rights
These laws establish a statutory or constitutional right to make personal decisions about reproductive health care, including contraception, safeguarding that right against future restrictions and protect against government and in some cases private interference.
Scope of practice
Scope of practice laws allow a broader range of health care providers to prescribe contraception, including advanced practice registered nurses (APRNs), nurse practitioners and physician assistants. This expands the provider network and improves access.
State funding
State funding initiatives allocate public resources to support access to contraception, particularly for low-income or uninsured populations. Examples include dedicated family planning grants and funding for safety-net providers.
Unbundling IUDs
Traditionally, intrauterine devices (IUDs) were billed as part of other treatments, such as part of the global maternity payment structure. However, IUDs have a significant upfront cost that may not be fully covered by those bundles. Through Medicaid SPA amendments and billing code guidance, states can allow providers to bill separately for IUDs and insertion services outside of global maternity or procedure payments, allowing expenses to be covered, reducing upfront costs and encouraging provider participation.