Cimini Bill Would Allow Medicaid Expansion for Family Planning

Rep. Maria Cimini has introduced legislation aimed at bringing Rhode Island in line with 22 other states that provide Medicaid coverage for family planning to low-income women who would qualify for Medicaid if pregnant.

The legislation is aimed at helping low-income Rhode Islanders plan their families responsibly and prevent unintended pregnancies that are costly both to those families and to taxpayers.

“Being able to plan pregnancy has a positive effect on the health and economic well-being of women and their families. For a low-income woman, an unintended pregnancy can be an enormous setback that limits her ability to get and keep a job, not just when she is pregnant, but for years unless she is able to afford child care,” said Representative Cimini (D-Dist. 7, Providence). “The goal of the bill is to help low-income women and couples wait until they are prepared to have children, which will help ensure more financial stability and better health outcomes and to save taxpayers’ money that would need to be spent for more costly coverage.”

The legislation would expand the federally funded, state-administered Medicaid program so it will allow family planning coverage for childless women who have income below 250 percent of the federal poverty level (FPL). Under current state law, RIte Care (the managed care Medicaid program) is available to pregnant women and children in families with income below 250 percent of the poverty level. Parents are eligible if their income is less than 175 percent of the federal poverty level. Women who receive RIte Care while pregnant but whose income exceeds 175 percent of the FPL can receive family planning services for two years after giving birth as long as income remains less than 250 percent of the FPL. The legislation would expand that family planning coverage to all women with income below the 250 percent level, regardless of whether they’ve had children, and without the two-year limit. Currently, 22 other states have such an expansion, including many of the southern states, California, New York and Pennsylvania.

Expanding the family planning benefit to childless women to help avoid unintended pregnancies would save considerable taxpayer money. The cost of providing family planning services is far less than the cost of providing full RIte Care for a woman who becomes pregnant, for the child and for the woman who may also be eligible as a parent. In addition, while the federal government shares around 50 percent of the cost of RIte Care coverage (and around 65 percent for prenatal care), it pays 90 percent of the cost for family planning services.

The Guttmacher Institute, a reproductive health and rights think tank, estimates it would cost the state $80,000 to implement the family planning expansion for one year, but that investment would save the state an estimated $352,000 in costs from unintended pregnancies – a net savings of $272,000.

While the taxpayer savings are substantial, Representative Cimini says her primary objective in filing the bill is to combat poverty in Rhode Island, since unintended pregnancies limit a woman’s ability to work and earn money, and increase expenses for her and her family. 

The bill is also good public health policy, since planned pregnancies tend to have healthier outcomes for women and children than do unplanned ones. Additionally, for many women who would be newly eligible for family planning services, the annual visit to a doctor for a birth control might be the only time she receives medical care, since someone with income below 250 percent of the poverty line has a high likelihood of being uninsured.

“Allowing low-income women the opportunity to wait until they are ready to have children is better for everyone: women, children, families and society. This is a relatively small investment, but it would result in significant savings for the state and individuals by helping many low-income Rhode Islanders remain self-sufficient,” said Representative Cimini.

The legislation (2012-H 7710), which is cosponsored by Rep. Eileen S. Naughton (D-Dist. 21, Warwick), Rep. Elaine A. Coderre (D-Dist. 60, Pawtucket), Rep. Lisa P. Tomasso (D-Dist. 29, Coventry, West Greenwich), Rep. David A. Bennett (D-Dist. 20, Warwick) and 17 other representatives, has been transmitted to the House Finance Committee.