Maryland Law Expanding Medicaid Access to Women’s Health Services Takes Effect


Last May, while the U.S. House and legislatures in various states were trying to defund family planning services, Maryland Governor Martin O’Malley signed the Family Planning Works Act into law.  The Act, which makes Medicaid-funded birth control, testing for sexually transmitted diseases, cancer screenings, and other essential services accessible to an additional 33,000  low- and moderate-income women in the states, has now gone into effect.

In an article last year in the Washington Post by the lead sponsors of the legislation, Democratic Delegate Heather Mizeur and Republican Delegate Michael Smigiel, asserted that the act makes sense both in terms of public health and economically:

Getting effective family planning to more women can help Maryland — one of the richest states in the nation — improve its dismal record of being the 13th-worst state for low-birth-weight babies and ninth-worst in infant mortality. Studies show that when a woman delays motherhood until she and her partner are ready to welcome a child into the world, their baby will be born healthier.

Family planning is also a winner for the state and federal budgets. It sounds impossible, but even in these tough fiscal times, expanding these services to tens of thousands of women — at a cost of $5.5 million per year, paid mostly by a generous federal Medicaid match — will save the state and federal governments tens of millions of dollars a year.

How so?

First, wrote Mizeur and Smigiel, “one must understand how things work in Maryland right now. (Or, to be more accurate, how they don’t work.)”

To protect the health of mothers and babies, we provide coverage for prenatal, birthing and neonatal care to low- and moderate-income women and their newborns. For each pregnancy whose costs are paid for by the state, Maryland spends nearly $20,000.

At the same time, we also offer family planning services — but only for a woman who has already given birth to her first child, and only if the state helped pay for her pregnancy care. That’s quite an odd policy, of course, because family planning is best begun before a family is started.

It is costly to state and federal budgets to pay for unintended pregnancies. Based on the experience of states that have similarly made family planning more available, experts at the Guttmacher Institute project that there will be 7,980 fewer unintended pregnancies (including 2,650 fewer abortions) per year in our state, saving Maryland as much as much as $39.5 million per year.

According to the National Women’s Law Center, support for the legislation was solidly bipartisan, with more than a dozen House Republicans joining almost all Democrats in voting to pass it. Nearly half the Senate Republican caucus supported it on the floor.

The bill’s authors wrote:

Family planning isn’t a Democratic issue, and it’s not a Republican issue. Progressives like Heather should support it because it’s good for the health of women and babies. Conservatives like Michael should support it because it dramatically reduces the number of abortions and saves taxpayer dollars. Everyone should support family planning because it improves lives while saving money…Despite our many differences, this bill helped us reach across the aisle to move our state forward.

If only common sense could go viral.

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