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Evaluation Design State of Wyoming Pregnant by Choice, Family Planning Waiver Program

A. General Background Information The purpose of Wyoming’s Family Planning Waiver, Pregnant by Choice Program is to provide family planning and reproductive support services to women who have received Medicaid benefits through the Pregnant Women Program and are no longer eligible for full Medicaid benefits. Eligible women would transition to the Pregnant by Choice Program with an approved application. Pregnant by Choice extends family planning options to women who would typically lose their Medicaid benefits up to two (2) months postpartum.

Contrary to the Pregnant by Choice Program, the Pregnant Women Program is a full benefit Medicaid plan. Benefits include physician services, transportation, rehabilitation, surgical services, and prescription drugs – all when medically necessary. The vision for these programs is that Pregnant by Choice and the Pregnant Women Program are complimentary to each other. Women aren’t dropped completely from coverage if they chose to transition to Pregnant by Choice with an approved application and Medicaid is able to support their family planning needs through offering limited reproductive health benefits. In turn, this aims to delay or suppress active Pregnant by Choice enrollees from additional pregnancies; thereby, reducing closely spaced pregnancies, achieving cost savings, reducing health risks to women and children, and decreasing the number of unintended pregnancies.

Eligibility and enrollment for both Programs are tracked in the Wyoming Eligibility System. This allows for ease of notification to women on the Pregnant Women Program eligible for Pregnant by Choice. Typically, eligible women are sent a notification at forty- five (45) days before their Pregnant Women Program benefits end to encourage them to continue their Medicaid coverage by transitioning into the Pregnant by Choice Program; however, with COVID-19 and the signing of the CARES Act, this process has been slightly changed. Eligibility rules have been relaxed, allowing Medicaid coverage to extend beyond the sixty (60) day postpartum period. Women eligible for the Pregnant by Choice Program must meet the following criteria: • Is transitioning from the Pregnant Women Program • Is age 19-44 • Is a U.S. Citizen • Is a Wyoming Resident • Is not eligible for another Medicaid Program • Doesn’t have health insurance • Must not have had a medical procedure to prevent pregnancy • Has an income less than or equal to 159% of the Federal Poverty Level Limited reproductive health benefits under the Pregnant by Choice Program cover: • Education about reproductive health and methods of birth control • Initial physical exam and health history, including a pap smear and testing for sexually transmitted diseases • Contraceptive management including prescriptions, devices, and supplies