SALT LAKE CITY — Every state offers different benefits to Medicaid recipients, and in Utah, family planning isn't included.
Rep. Ray Ward, R-Bountiful, proposed HB12 as a "small change in policy" that will lead to big savings in the state budget in terms of decreasing unwanted pregnancies, lowering the cost to the state to feed infants and children in low-income households and reduce the risk of preterm births for women having children close together.
Offering women on Medicaid a "more effective form of birth control" — an intrauterine device, or IUD, Ward said, "is a really good idea."
He initially wanted the state to adopt a pilot program but has changed his stance, saying it makes sense to keep the program around, revisiting it in the first four years to make sure it is working the way it should.
An IUD typically has an upfront cost of about $700 to $800, but has the best long-term success rate among birth control methods.
"Condoms are less expensive," Ward said. "Unless you count the failure rate, then they're not so inexpensive."
But access to IUDs for people in poverty is scarce. And many, if they can afford it, end up getting birth control pills or use other, less effective methods.
"If they're not satisfied with the method they have, they don't use it," Jessica Sanders, director of Family Planning Research at the University of Utah's School of Medicine, told members of the House Health and Human Services Committee. She said a portion of patients also have medical issues with taking the pill.
Rep. Norm Thurston, R-Provo, said he was concerned that an IUD wouldn't protect against sexually transmitted diseases, adding that the state already "spends a lot of Medicaid money to clean up the 'hep C' thing."
Ward said hepatitis C, however, is transmitted through used needles and not via sexual activity. He clarified that an IUD does not protect against sexually transmitted infections, but offering family planning counsel can help with that, too.
"We're taking people who have access to nothing and giving them something that works really well," Ward said, adding that it would cost the state about $800,000 a year, with two-thirds of that money coming back in federal Medicaid reimbursements.
Other members of the committee said cost wasn't the only issue.
"The one thing we're trying to prevent here is unintended pregnancies, which have their own long-term implications," said Rep. Edward Redd, R-Logan. "IUDs have a clear-cut advantage in their effective rate."
The bill gets a stamp of approval from the Utah Medical Association, which supports the new service being offered to Medicaid patients. And the Utah League of Women Voters also supports the measure, as Vickie Samuelson said the organization believes "quality, affordable health care should be available to all citizens."
"There's a lot of prenatal counseling that goes into contraception after birth," labor and delivery nurse Carrie Norton told lawmakers. "It's important that we offer the option in the hospital."
Norton said about 40 percent of women "don't make it" to their appointment, typically set six weeks after delivery, where contraception is discussed.
Thurston was the only committee member to oppose the bill, which now heads to the House for further discussion and a vote.
Rep. Paul Ray, R-Clearfield, said $800,000 is a "small investment," a drop in the bucket when it comes to the state's $4 billion Health and Human Services budget.
"It seems like something we ought to be doing," he said.