Illinois law requires the state to provide coverage for all lawful reproductive health care, including all FDA-approved methods of contraception, to individuals who receive their health insurance through its Medicaid program. At the same time, however, Illinois women of childbearing age actually access contraceptive services through Medicaid coverage – especially long-acting reversible contraceptives (LARCs) like intrauterine devices (IUDs) and contraceptive implants – at below average rates. Exploring Network Barriers to Accessing Contraception for Illinois Medicaid Recipients, a joint report from the ACLU-IL, ICAN!, and researchers from the University of Chicago Department of Family Medicine, explores why this is the case.

The Illinois Medicaid program contracts with Managed Care Organizations (MCOs) to deliver health care services to recipients via their networks of providers across the state. Through analyzing hundreds of patient simulation calls conducted to Peoria- and Effingham-area providers identified as in-network Obstetrician/Gynecology or Family Planning providers by the state’s five main MCOs, the report identifies practical barriers to contraceptive access that may be experienced by Medicaid recipients attempting to use their insurance coverage to obtain their preferred method of contraception. These barriers can include outdated or inaccurate information in network directories, excessive wait times for appointments, and providers who don’t offer all FDA-approved contraceptive methods. These barriers can also include providers who do not offer contraception because of religious objections by the provider themselves or their health system.

Overall, only one in seven provider contacts in the patient simulation calls resulted in access to the specific contraceptive method of choice within five weeks. And at least one provider in the majority of the Medicaid MCO networks for Peoria and Effingham reported being unable to provide birth control for pregnancy prevention or only offering natural family planning services.

The report recommends steps that the State can take to improve access to timely, high-quality contraceptive care for those who receive their health insurance through its Medicaid program.