Alabama and Mississippi have extended limited Medicaid coverage to men with incomes over the federal poverty level for family planning services that include screening for sexually transmitted diseases.
The policy changes could not only reduce unwanted pregnancies, but also curtail the spread of sexually transmitted diseases that are rampant in both states.
“We have some of the highest rates of gonorrhea and chlamydia in the country and the STD services we had in place mostly targeted women,” explained Dr. Leandro Mena, director of the Center for HIV/AIDS Research, Education and Policy at the University of Mississippi Medical Center, Jackson. The change “expands access to men to these important screening services regardless of their ability to pay.”
Others agreed. “Mississippi has very alarming numbers when you look at HIV disease and at-risk behavior among the young people we serve,” said Dr. Janice Bacon, CEO of G.A. Carmichael Family Health Center in Canton. “The family planning waiver changes will serve as a key vehicle in our endeavors to reach this population and hopefully improve our outcomes related to HIV counseling.”
Mississippi and Alabama have some of the highest rates of chlamydia, gonorrhea and syphilis in the nation, federal data show.
The states were able to extend coverage to men after the CMS approved changes to long-standing Medicaid family planning waivers that until this year only covered services for women.
Spokeswomen for both states' Medicaid agencies confirmed the change, but declined to say why the decision was made to add coverage for men under the waivers.
In Alabama, men with incomes up to 141% of the federal poverty level will now have access to care. Men with incomes up to 194% in Mississippi will now be covered.
As many as 240,000 men and women in Alabama are expected to receive services under the waiver by 2017. More than 25,000 are expected to do so over the same period in Mississippi. Neither state provided men-only projections.
The expanded coverage for males surprised some.
“Many states in the Southern U.S. don't provide as much aid as those in the Northern U.S. or liberal states like California, so it's even more noteworthy the steps that Mississippi and Alabama are taking,” said Alicia Bonaparte, associate professor and medical sociologist at Pitzer College in California.
In all, 15 states have demonstration waivers that provide family planning services to individuals not otherwise eligible for Medicaid, but only five do so for men. Alabama and Mississippi are the only ones to do so in the South, according to the Guttmacher Institute, a not-for-profit organization that works to advance reproductive rights and health.
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