As part of its efforts to ensure that all women, regardless of race, income, geographic location or immigration status, have access to family planning services, the Southwest Women’s Law Center launched an effort to increase eligibility and utilization of a special Medicaid program know as the “Family Planning Waiver”. SWLC’s work focuses on the complex regulatory issues that confront the state health care providers and patients in implementing and maximizing participation in this important public program. SWLC will continue its work to expand New Mexico’s Family Planning Waiver and will seek opportunities to identify and eliminate barriers facing women seeking healthcare services under government benefits programs.
Family Planning Benefits in New Mexico
Medicaid’s Family Planning Waiver: How Do We Increase Access?
What is the medicaid family planning waiver? Medicaid allows states to waive the regular Medicaid income requirements so that women who do not qualify for full Medicaid benefits still qualify for family planning services. New Mexico’s waiver program currently covers women up to 185% of the federal poverty level ($32,560 for a family of three).
Providing family planning to women is sound fiscal policy for the state of New Mexico. For every $1 New Mexico invests in family planning services, the U.S. government matches $9. For every $1 spent to avoid unintended pregnancies, the government saves $4 on Medicaid-funded pregnancy related care.
The need for family planning benefits is great. Approximately 140,000 New Mexican women of reproductive age are in need of publicly funded family planning services. Nearly one-third of reproductive age women in New Mexico are uninsured. While other states with family planning waivers serve more than 70% of eligible women, New Mexico’s waiver program serves less than 20% of eligible women.
How can New Mexico meet this need and maximize the federal match for family planning? The low number of eligible women benefiting from the family planning waiver is a community problem that we must address together. Steps include:
Implement point-of-service, same-day enrollment for family planning waiver program enrollees, just as the state has for pregnancy-related care, breast and cervical cancer, and children; eventually allow for presumptive eligibility. This includes reimbursing providers for the application assistance that they provide to clients in lieu of sending clients to an Income Support Division office.
Simplify the application so that it is not as difficult for enrollees as the full Medicaid application.
Conduct outreach and education to providers, and potential and current enrollees.
In a better economy, expand New Mexico’s income eligibility to 200% of the federal poverty level, as other states have.
Include all income eligible women, regardless of age.
Will Medicaid Expansion Cover Family Planning and Maternity Care Benefits?
Yes! On January 1, 2014, New Mexico expanded full coverage Medicaid to adults ages 19-64 who make less than 138% of the federal poverty level (about $16,000 for an individual and about $32,500 for a family of four). This expanded Medicaid coverage includes family planning services and maternity care benefits. The Southwest Women’s Law Center continues to advocate that the state of New Mexico continue its current, higher levels of coverage for family planning and maternity care Medicaid Coverage.
