Medicaid Coverage of Plan B[R] Over-The-Counter: New York State's Experience

Advocates fought for years to make emergency contraception (EC) available over-the-counter so that women could have convenient and timely access to this contraceptive option when they needed it. But removing the prescription requirement created a new barrier for some women--over-the-counter drugs are usually not covered by insurance, so the change increased the expense of getting EC for women who might otherwise have been able to get it at low- or no cost. In some states, including New York, advocates figured out a solution to this problem, working with the state to pay for EC for women receiving Medicaid. The Education Fund of Family Planning Advocates of New York State (Ed Fund) studied the experience with Medicaid coverage of EC and produced a policy brief with recommendations to help ensure that low income women's access to EC is not impaired by unnecessary barriers. That report is excerpted below. In August 2006, the Food and Drug Administration (FDA) approved over-the-counter sale of Plan B[R] emergency contraception (EC) for women 18 years of age and older--significantly expanding access to this sale and effective method of preventing unintended pregnancy. (1) (Access will expand even more as a result of a recent court decision ordering the FDA to change the age limit to 17 and to consider completely eliminating age limits.) Despite being available over-the-counter (OTC), the retail price of Plan B[R] ($35--$60) remains a significant barrier for low-income women. (2) Several states have addressed this barrier by paying for EC through the Medicaid program. The Ed Fund, which has been working with state agencies and other organizations to expand access to EC, recently released a study of the effect of this coverage decision.