The Missouri Department of Social Services has submitted an application to the Centers for Medicare and Medicaid Services that would use federal funds to pay for a program providing family planning, contraception and disease testing for low-income, postpartum women.
If approved, the federal government would pay for 90% of the program’s cost. State officials say it would decrease unplanned pregnancies and prevent sexually transmitted diseases. But critics say the program won’t reach low-income women who need it the most, because the waiver would bar clinics that offer abortions from participating.
“We support the effort to get the federal dollars Missourians deserve for these important services, [which are] fundamentally the services that Planned Parenthood specializes in providing,” said M’evie Mead, director of policy and organizing at Planned Parenthood Advocates in Missouri. “But to do it in a way that cuts off access to a key part of the population … is a discriminatory act.”
Many poor women use clinics operated by Planned Parenthood, the only abortion provider in the state, to access services such as contraception and pap smears, Mead said.
The provider restrictions “put an unnecessary strain on an already burdened health system,” said Andrea Waner of Columbia during a public comment session last month. “It’s counterproductive to the health of the Missouri people.”
Missouri for years operated a similar family planning program with federal Medicaid dollars, but the state began rejecting millions in federal funds in 2017 after the Legislature passed a law that barred appropriations from going to organizations that provide those services, even indirectly.
The program continued, but with state funding and provider limits.
Officials from the Department of Social Services declined requests for interviews.
The state Supreme Court earlier this year found the Department of Social Services was legally bound to reimburse Planned Parenthood for treating Medicaid patients. Mead hopes that decision sets a precedent.
The submitted application is what’s known as a “demonstration” waiver. States create their own rules to offer services to Medicaid patients with hopes of proving better health outcomes and submit their plans to the government for approval. If approved, CMS will fund the demonstrations for a set amount of time, usually a few years.
The waiver under consideration would run through December 2023 and would provide pap smears, pelvic exams and family planning counseling for one year to those who lose Medicaid coverage after giving birth. (MO HealthNet, the state’s Medicaid program, cancels coverage for new mothers 60 days after giving birth.)
Mead said while previous administrations would have rejected the waiver based on its provider limits, CMS has already approved a similar Medicaid program in Texas.
The program received more than 900 comments during a public comment period. If approved, it will begin in January of next year.
Planned Parenthood is an underwriter of St. Louis Public Radio.
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