February 20, 2013 — To ensure their clients benefit from expanded contraceptive coverage under the Affordable Care Act (PL 111-148), family planning centers need to begin contracting with more insurers and revamping their computer systems, according to a Guttmacher Institute study, Kaiser Health News' "Capsules" reports.
Rules being implemented under the ACA require most health plans to cover contraceptives at no added cost to beneficiaries. However, many family planning clinics do not accept insurance; in 2010, one-third of centers had contracts with private insurers and 40% had contracts with Medicaid.
Further, even though about one-fourth of women who need contraception rely on family planning centers, only 60% of the clinics' clients had public or private insurance in 2010. Many clients pay on an income-based sliding scale or receive services through the federal Title X family planning program or state programs.
Under ACA provisions that take effect in 2014, many more women will become eligible for Medicaid or gain access to private health plans through state exchanges.
"For all family planning centers, becoming adept at working with health plans as a way to secure third-party reimbursement for insured clients will be necessary to thrive in the emerging health care marketplace," the Guttmacher report said (Andrews, "Capsules," Kaiser Health News, 2/19).