The Affordable Care Act (ACA) brought sweeping changes to the Medicaid program that have had profound implications for family planning coverage, services and providers. In particular, in the 17 states with family planning programs that have expanded Medicaid, many women have moved from limited benefit family planning programs into full-scope Medicaid or Marketplace insurance and now have comprehensive coverage, although it is less focused on family planning services.

In light of the coverage trends and other ACA-related changes, Manatt Health prepared a new white paper for the Kaiser Family Foundation that describes the impact on women and their partners, as well as on family planning providers, of the shifting landscape for family planning. Based on case studies in six states and interviews with national experts, providers, advocates and government officials, the paper describes major trends in how women secure Medicaid family planning coverage and services, the implications of ACA-related changes for family planning providers, and the role of family planning more broadly in Medicaid delivery system reform initiatives.

The study was conducted in the summer of 2016—before the November election changed the outlook for the ACA and Medicaid. With Medicaid reform under debate at the federal and state levels, it is important to understand the role of family planning programs and how they could be affected by Medicaid re-structuring.