Lawmakers Introduce Bill to Allow States to Expand Medicaid Family Planning Services Without Waiver

Sens. Lincoln Chafee (R-R.I.) and Diane Feinstein (D-Calif.) yesterday introduced legislation -- called the Family Planning State Empowerment Act of 2001 -- that would allow states to expand family planning services to women under Medicaid without needing a federal waiver (Chafee release, 8/2). The federal government recently decided to reject all pending waiver requests from states asking to expand contraception coverage and other family planning services through their Medicaid programs. Although Medicaid does not cover most abortion services, states were permitted in the mid-1990s to expand family planning benefits through Medicaid by applying for waivers. For their part, Bush administration officials said that they "were not against expanding family planning services" but instead had decided to require states to expand their Medicaid programs in general through "comprehensive," instead of single-issue, changes (Kaiser Daily Reproductive Health Report, 7/20).

The Proposal
Under the proposed bill, states could extend family planning services under Medicaid to women with incomes up to 185% of the federal poverty level without applying for a federal waiver from HHS. "Eliminating the waiver requirement will facilitate state innovation and provide assistance to more low-income women," thereby allowing states to expand services "without having to combat a lengthy, cumbersome and uncertain" waiver process, Chafee said. The bill also would allow states to provide family planning services under Medicaid to low-income women at any time after childbirth, eliminating the federal time limit of 60 days postpartum. In addition, the legislation would allow states to extend family planning services for up to one year to women who lose Medicaid eligibility "because of an increase in income." Reps. Nita Lowey (D-N.Y.) and Jim Greenwood (R-Pa.) have introduced a similar bill in the House (Chafee release, 8/2).

Other Efforts to Provide Coverage
The introduction of the Chafee-Feinstein bill follows a letter sent to HHS Secretary Tommy Thompson last week requesting that the administration reverse its decision to reject all pending state requests for waivers to expand contraceptive coverage and other family planning services through Medicaid. The letter, prepared by Sens. Hillary Clinton (D-N.Y.) and Charles Schumer (D-N.Y.) and signed by 20 Democrats, one Republican and one independent, said that the administration's decision to turn down the funding proposals "undermines efforts to reduce unintended pregnancies and improve maternal and infant health." In addition, the letter "voiced concern that the administration would not allow similar Medicaid plans that have already been implemented in other states to continue" when they come up for reauthorization (Kaiser Daily Reproductive Health Report, 7/30). Since the early 1990s, 14 states have been granted family planning waivers to extend coverage to those low-income women and men who would not otherwise qualify for Medicaid, according to the Alan Guttmacher Institute.