Medicaid Family Planning Eligibility Expansions

August 31, 2023

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.

Highlights

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.

Current Policy Status Table

Medicaid Family Planning Eligibility Expansions
STATE	BASIS FOR ELIGIBILITY		ELIGIBLE POPULATION INCLUDES		ORGANIZED AS A:		WAIVER EXPIRATION DATE
STATE	Based Solely on Income	Losing Full-Benefit Coverage	Men	Individuals <19	State Plan Amendment	Waiver	WAIVER EXPIRATION DATE
Alabama	146%^†*		X			X	9/30/22
California	200%		X	X	X		N/A
Colorado^⌘
Connecticut	263%^†		X	X	X		N/A
Florida		For any reason		X		X	6/30/23
Georgia	200%*			‡		X	12/31/29
Indiana	146%^†		X	X	X		N/A
Iowa^Ψ
Louisiana	138%^†		X	X	X		N/A
Maine	214%^†		X	X	X		N/A
Maryland	259%*		X	X	X
Minnesota	200%		X	X	X
Mississippi	199%^†*		X	X		X	12/31/27
Missouri^Ψ
Montana	216%^†*					X	12/31/28
New Hampshire	201%^†		X	X	X		N/A
New Jersey	205%		X		X
New Mexico	255%^†		X	X	X		N/A
New York	223%^†*		X	X	X		N/A
North Carolina	200%^†		X	X	X		N/A
Oklahoma	138%^†*		X	X	X		N/A
Oregon	250%		X	X		X	12/31/21
Pennsylvania	220%^†		X	X	X		N/A
Rhode Island		Postpartum		X		X	12/31/23
South Carolina	199%^†		X	X	X		N/A
Texas	200%	Postpartum		‡		X	12/31/24
Vermont^Ψ
Virginia	205%^†*		X	X	X		N/A
Washington	260%*		X	X		X	12/31/23
Wisconsin	306%^†		X	X	X		N/A
Wyoming		Postpartum				X	12/31/27
TOTAL	24	4	21	21	17	10
⌘ Colorado enacted a law in 2021 that directs the state to apply to the US Centers for Medicare and Medicaid Services to expand Medicaid family planning services to individuals with incomes up to 265% of the federal poverty level; the program has not been approved. * State also extends Medicaid eligibility for family planning services to people losing full-benefit coverage after the end of the postpartum period. † This eligibility ceiling includes a standard “disregard” to an applicant’s income equal to five percentage points of the federal poverty level. ‡ Includes 18 year olds but not younger individuals. Ψ The state operates an entirely state-funded program to provide family planning services. In Iowa, individuals with incomes up to 300% of the federal poverty line (FPL) are eligible. In Missouri and Texas, women at least 18 years of age with incomes up to 185% of the FPL are eligible. In Missouri, women losing Medicaid postpartum are also eligible. In Vermont, anyone with an income up to 200% of the FPL is eligible.