HB12: Legislature passes Medicaid family planning services bill

The Utah House is considering a bill that would allow Medicaid to pay for contraception after birth. (AP Photo/Rick Bowmer)

A Utah House committee passed a bill Jan. 24 on family planning service amendments that would require the Medicaid program to cover the cost of contraceptives immediately after childbirth.

Rep. Raymond Ward, R-Bountiful, is sponsoring HB12 which would require the Medicaid program to cover “long-acting reversible contraception,” such as intrauterine devices (IUDs) or contraceptive implants, offered immediately after childbirth while the mother is still in the hospital.

Contraceptives, including such long-acting devices, are already covered for Medicaid patients, but have not been previously available for coverage in hospitals immediately after childbirth, according to Ward.

The bill would also provide family planning services to low-income individuals such as: sexual health education, family planning counseling, medical diagnosis, treatment or preventative care.

“Family planning services” referred to in this bill do not include abortion, and would be available to individuals with an income level equal to or below 95 percent of the federal poverty level, or to individuals who do not qualify for full coverage under the Medicaid program.

Ward invited Dr. Jessica Sanders, a research professor at the University of Utah School of Medicine who specializes in OB-GYN, to testify in favor of the bill.

Sanders said she was involved in a research project from March 2016 to March 2017 where about 2,000 low-income women without insurance were offered no-cost, long-acting contraceptives.

“What we saw was an increase in the use of more effective methods which have been shown to have better outcomes for those individuals, as well as cost savings,” Sanders said. “We’ve also seen that when people are not satisfied with their method, they don’t use it.”

Aside from his responsibilities as a representative, Ward is a practicing family physician. He said he believes there are many benefits to this bill, but two main reasons he focused on were finances and the lives of individual women.

“The states that have done this waiver and then looked at it have found savings to their state budget,” Ward said. “Those savings accrue because of decreased unwanted pregnancies, decreased amount of women needing WIC (Women Infant Children) services they have to cover, decreased abortions that the state has to cover, decrease in pre-term births that happen more often when pregnancies are spaced more closely together.”

Women Infant Children is a supplemental nutrition service funded by the government to provide supplemental foods to pregnant and breastfeeding women and their newborns

Ward said Utah is now one of only seven states that doesn’t have this waiver, but not only because of the financial benefits.

“When a woman is able to choose when to form their family, it makes sense that they would be able to make their life turn out better,” Ward said. “To finish school in the proper way that they want to before they have a family, to have their life stable to be able to take care of their children, it makes sense to me that this would benefit them.”

Rep. Norm Thurston, R-Provo was the only representative who opposed the bill in committee. He said he was concerned some people who are now paying for their own birth control would switch over to this form so the state could take care of their bill.

“I’m not convinced, at this point, that there aren’t already resources out there for people who are in need. This is not about what’s best for people or not best for people, I believe people should be able to choose what’s best for themselves,” Thurston said. “The challenge that I have is with the argument that we should take financial responsibility for this decision so that we can avoid the responsibility for other bad decisions.”

Reps. Paul Ray, R-Clearfield, and Steve Eliason, R-Sandy, both said they believe the bill would shrink costs for the state in the long run.

“This is the better thing to pay for,” Ray said.

Rep. Edward Redd, R-Logan, who has also practiced internal medicine and worked as a medical officer for the Bear River Health Department, said situations differ from case to case, but he ultimately believed HB12 would have positive impact.

“I think the one thing we’re trying to prevent here is unintended pregnancies, which have their own long-term complications in the form of, sometimes, really bad outcomes in families, and sometimes problems with children being raised in situations that are not optimal,” Redd said. “When parents are stressed out financially and have unintended pregnancies, sometimes they step up to the plate and do a wonderful job, but sometimes it doesn’t always happen that way.”

Many people showed up to testify on the bill.

Some of the concerns included effect on transmission of STDs, not knowing how many women it would affect, high pressure on women to make this decision immediately after giving birth and whether it is necessary to create yet another government program.

Despite these concerns, HB12 was sent out of committee with a favorable recommendation. It will move on to the House floor, where the House of Representatives will discuss it collectively and determine its fate.

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