CMS to Reject All Pending State Requests for Family Planning
The federal government has decided to reject all pending waiver requests from states asking to expand contraception coverage and other family planning services through their Medicaid programs, the Washington Post reports. State Medicaid programs cover limited family planning services, but not abortion services. The 1976 Hyde Amendment prohibits federal funding of abortions through Medicaid except in cases of rape, incest or life endangerment of the woman. States, however, were permitted in the mid-1990s to expand family planning benefits through Medicaid by applying for waivers. The Bush administration recently denied a waiver request from Georgia, the Post reports. Georgia had requested that its Medicaid program be expanded to cover services such as condoms, birth control pills, hormone injections and tubal ligation for new mothers for up to two years following delivery (Kaufman/Vedantam, Washington Post, 7/20). In addition, a New York waiver to expand contraceptive coverage eligibility has been "verbally denied" by the Bush administration, the AP/Albany Times-Union reports. New York has sought to expand contraceptive coverage to women with annual incomes of 200% of the poverty level. Currently women at 185% of the poverty level or lower can receive the benefit (McCaffrey, AP/Albany Times-Union, 7/20). Waivers from Kentucky, Michigan, Wisconsin, Colorado, North Carolina and Mississippi are also "likely to be turned down under the new policy," the Post reports.
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. Peter Ashkenaz, spokesperson for the Centers for Medicare and Medicaid Services (formerly HCFA), said, "We denied the (Georgia) waiver because it was a stand-alone waiver just for one program. If another program comes in that it is just for mental health, that would [also] be denied." Federal officials acknowledged that all the denied requests involved family planning, however. Ashkenaz said that if family planning programs are part of a larger primary care initiative, "the sense is that is would be funded." He added, "We will go to the states and tell them about the policy and that we will work with them. [HHS Secretary Tommy Thompson] believes that health care should provide some access to primary care. He wants to make sure the uninsured have primary health care."
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Some "critics" and state officials "questio[n]" the administration's reasoning for the move, the Post reports. Martin Smith, spokesperson for the Georgia Department of Community Health, which runs the state's Medicaid program, said, "We were told basically that this administration was not interested in approving any family planning waivers," adding that he was "aware that administration officials were publicly offering a different reason." Health advocates have said that the move is "harmful to poor women and an example of the Bush administration's conservative stance on sexual and reproductive issues" (Washington Post, 7/20).