Hundreds of thousands of men and women who earn up to $2,134 a month are now eligible for a suite of family planning services — including birth control, pregnancy tests and sterilization surgery — thanks to New Jersey’s new Medicaid expansion.
The state Department of Human Services rolled out the Plan First benefit earlier this month to help individuals who earn too much for the traditional Medicaid program to access certain family planning services, without paying out of pocket. It does not provide full health insurance benefits and does not currently include abortion coverage, DHS said.
The expansion is based on legislation Democratic Gov. Phil Murphy signed in February 2018 as one of his first official acts in Trenton — the same day he restored state funding for family planning services that Gov. Chris Christie, a Republican, had discontinued. But the Medicaid expansion concept actually dates to the end of the tenure of former Gov. Jon S. Corzine, another Democrat, although it was also defunded by Christie soon after the latter took office.
In addition to condoms and other contraception, Murphy’s Plan First covers pregnancy tests, screenings for HIV and other sexually transmitted diseases, counseling sessions related to reproductive planning and certain immunizations. Sterilization surgery is covered in the form of tubal ligations for women and vasectomies for men over age 21.
There is $17.8 million for these services included in Murphy’s budget for the current year. All but $1.8 million will come from the federal government, DHS said. (Corzine had budgeted $1 million for his plan, which was expected to get a $9 million federal match.)
More access to critical services
“Plan First increases our residents’ ability to obtain critical health care services,” said First Lady Tammy Murphy, who joined DHS officials for the announcement. “By expanding access to reproductive health care, we are working to ensure healthier mothers, babies, and families.”
Tammy Murphy has prioritized improving maternal health care through the Nurture NJ campaign, which is designed to improve birth outcomes and reduce racial disparities. The Garden State has one of the highest maternal death rates in the nation, and black women are at least four times more likely to die of childbirth-related causes than their white counterparts.
The new benefit drew praise from family planning experts at Planned Parenthood and the New Jersey Family Planning League, who said Plan First will help low-income women who don’t have access to quality care and that it will also reduce unplanned pregnancies. Other experts said it is especially timely given the rising rates of STDs, many of which have increased nationwide by double-digit percentages over the past four years.
While the state has embraced progressive reproductive health policies over the years, a 2018 report published by the liberal-leaning think tank New Jersey Policy Perspective found that contraception, abortion and other services remain out of reach for some women. The study found poor, nonwhite and transgender women are more likely to face economic, transportation and other challenges that limit their access to family planning tools.
“The Murphy Administration is committed to providing women coverage for quality, affordable health care,” DHS Commissioner Carole Johnson said. “Family planning is an essential health care service, and we are pleased to have been able to work with the Legislature, the health care provider community, and women’s advocates on the design and implementation of this critical benefit.”
Heather Howard, a lecturer at Princeton University’s Woodrow Wilson School of Public and International Affairs, who served as state health commissioner under Corzine, said Plan First may have a wider impact than initially appears. “Something I learned as commissioner is that family planning is the key entry point for many young people into the health care system, so this isn’t a limited benefit program for reproductive-age people, it’s basic health care,” she said.
At least two dozen states have expanded their Medicaid programs to cover family planning services for residents whose incomes exceed the traditional threshold for the public insurance plan, according to the Guttmacher Institute, which studies reproductive health. Most cap this benefit at around 200% of the federal poverty limit (FPL).
NJ’s initiative stands out
Howard said most of these existing family planning expansions are in states that did not grow their Medicaid programs under the national Affordable Care Act, or Obamacare, which provided new federal funding to cover a greater share of working-poor residents. This makes New Jersey’s initiative somewhat unusual.
The Garden State already covers all health care services for pregnant women who earn up to 200% of the federal poverty limit under its traditional Medicaid program; children in families who earn up to 355% of this limit can also get full coverage under the plan. Adults can qualify for full Medicaid if they make less than 138% FPL, or around $17,240 a year.
Plan First covers family planning services only, but is open to men and to women who are not pregnant and make between 138% and 205% FPL, or $25,605 annually. According to U.S. census data, more than 800,000 residents have incomes that fall into that range.
Under Murphy, New Jersey also enhanced the existing Medicaid program to cover services from doulas, or non-clinical birth coaches, who are seen as important in improving maternal care outcomes, and the state is looking to add a prenatal class benefit, as well. Murphy has signed a slew of other measures designed to reduce maternal and infant deaths statewide, among all income levels.
Title X funding
In addition, the Democratic administration in New Jersey has fought in court to protect Title X funding, a critical source of federal family planning resources, which has come under attack by Republican President Donald Trump. And Murphy restored $7.45 million in annual state dollars for these services, a budget line that was suspended during Christie’s eight years in office.
“Women are finally getting the family planning services they need and deserve under Governor Murphy’s administration,” said Senate Majority Leader Loretta Weinberg (D-Bergen), a longtime advocate for women’s health care. “After the prior administration redlined services, it is so important to see this expansion.”
Interested individuals should visit NJFamilyCare or call 1-800-701-0710 to apply for Plan First.