Changes are needed to Medicaid at the federal and state levels to increase women’s access to long-acting reversible contraceptives after childbirth and abortion care. Source: iStockphoto
Washington, D.C. —(ENEWSPF)–June 9, 2016. Long-acting reversible contraceptives, or LARCs, are highly effective family-planning methods. However, due to a variety of policy barriers, many women who receive their health insurance through Medicaid are not able to access LARCs directly after childbirth or receiving abortion care. Today, the Center for American Progress released a report identifying many of these barriers and offering legislative and regulatory state and federal policy solutions to improve access to LARCs for all women.
Studies have shown that women who choose to use LARCs—which include intrauterine devices, or IUDs, and hormonal implants—have a much lower risk of contraceptive failure compared to users of oral contraceptive pills, transdermal patches, or vaginal rings. Furthermore, LARCs are considered very safe for immediate placement both postpartum and postabortion and can help prevent the health and financial risks of repeat unintended pregnancies.
“Women need to be able to fully evaluate all of their contraceptive options to determine the right decision for themselves,” said Maggie Jo Buchanan, Associate Director of the Women’s Health and Rights Program at the Center for American Progress. “The United States has an unacceptably high unplanned pregnancy rate, and for many, the ideal time to start contraception may be immediately after a birth or an abortion. While women should make that determination through open dialogue with their clinicians, state and federal officials can act now to ensure there are no obstacles that keep them from doing so.”
Despite the effectiveness of LARC methods, use of LARCs in the United States is still lower than that in most developed nations. Furthermore, within Medicaid, there are several policy barriers that delay or prevent women from accessing LARCs postpartum and postabortion, such as provider misconceptions about LARCs, billing practices, and public funding restrictions.
To that end, CAP’s report puts forth a series of recommendations to increase access to postpartum and postabortion LARC services:
To increase access to postpartum LARC services, CAP recommends that the Centers for Medicare and Medicaid Services, or CMS, improve federal guidance on immediate postpartum placement to ensure providers are able to easily bill for LARC services. Meanwhile, states can continue to expand their own efforts and should evaluate other states’ approaches to either adopt or create their own approach.
To increase access to postabortion LARC services, CAP recommends that CMS issue clarifying guidance supporting LARC access immediately postabortion while also explaining how billing can be done without violating the Hyde Amendment. Meanwhile, CAP calls for the elimination of restrictions on the ability of government-sponsored insurance to cover abortion care, which can create unnecessary confusion around billing. State health departments should also issue guidance clarifying that billing for LARC insertion postabortion does not violate any of their own restrictions.
Finally, CAP recommends that both federal and state governments should increase provider awareness and knowledge of LARCs and their use in postpartum and postabortion settings.
Read the report: Helping More Women Access Long-Acting Reversible Contraceptives by Maggie Jo Buchanan and Donna Barry
- Changing the Conversation on Abortion Restrictions: A Proactive Response to Political Interference in Health Care by Donna Barry, Andrea D. Friedman, and Sarah Lipton-Lubet
- Improving Abortion Access by Expanding Those Who Provide Care by Donna Barry and Julia Rugg
- Access to Contraception for Women Serving in the Armed Forces by Julia Rugg and Donna Barry
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