Want to Fight for Reproductive Health? Fight for Medicaid, Too.

Medicaid, the largest public health insurance program for people in the United States, exists on a state-by-state basis. But how could Medicaid possibly relate to sexual and reproductive health? Fabiola De Liban, Director, Sexual and Reproductive Health, with the National Health Law Program, sits down to talk with us about what is covered under the program, what’s not covered, Medicaid’s disturbing history related to family planning, and the barriers that patients face on a day-to-day basis. 

Medicaid is the largest public payer of family planning, covering 75% of all family planning expenditures. It covers almost half of U.S. births, including prenatal, labor, delivery, and postpartum. Medicaid also covers prescription drugs, sterilization, breast cancer services, and some gender -affirming care services. Medicaid does not cover abortion due to the Hyde amendment. Medicaid expansion allows someone who is not pregnant or who doesn't have a child or a disability to be able to qualify to the Medicaid program. When the Affordable Care Act passed, Medicaid expansion would have gone into effect nationwide, if not for states who sued to prevent expansion. Medicaid expansion is now optional, with only 9 states having chosen to not expand.

Links from this episode

National Health Law Program
National Health Law Program on Facebook
National Health Law Program on X
Ending Hyde is a Step Towards Abortion Justice
An Advocate's Guide to Reproductive and Sexual Health Care in the Medicaid Program
Abortion Coverage Under Medicaid
Section 1557 Complaint  Link 
NHeLP's Doula Medicaid Project

Take Action

Transcript

Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

Read More

Hi rePROs! How's everybody doing? I'm your host Jennie Wetter, and my pronouns are she/her. So, I hope everybody had a lovely weekend. I had a really chill one and it was kind of needed. All this SCOTUS stuff is really stressing me out, man. And I was really starting to stress about, well, I told you I'm already really stressed about the EMTALA case, like I really am bracing for something terrible, but I was really starting to stress about the Rahimi case the longer it went without a decision on that one. And I was just so relieved...the exhale that left my body when I saw that the Supreme Court decided eight to one. Like, that's amazing. With only Thomas dissenting to keep guns out of the hands of domestic abusers, people who are under a restraining order for domestic abuse. That's just amazing. Like, you know, I've talked about my experience with intimate partner violence. This is something that's near and dear to my heart. And so, I was just, I had, I didn't quite realize how much tension I had been holding around that case until the decision came down. And I just, like I said, there was just this huge exhale and relief, just for me, for anybody who has experienced or is experiencing intimate partner violence, domestic violence, this is huge. It's gonna save lives. You know, a woman is five times more likely to die if there is a gun in her abuser's hands. This is a lifesaving decision and I'm really so happy and just utterly relieved that it came out the right way. Like I said, I was feeling fairly confident about that after the case was argued, but just the longer June went on, I start my, I could feel my stress, like, starting to ramp up. So, that was really lovely to go into the weekend with a good decision. I was a little worried it was gonna go into the weekend with a terrible decision unless things have changed between when I record this and when this comes out. The next decision day is tomorrow, it's Wednesday. So, like I said, we're still waiting on EMTALA and still have a very, very bad feeling about that one. So, you know, keep an eye out. I mean, it could come out, it should come out this week, but there are still quite a few large cases remaining, so it could actually go into July, but the hope is that we'll be, we'll get all the decisions this week. So, yeah. Very stressed, but I at least was able to go into the weekend with, like, a big win, which was lovely. I think that's kind of all like, I was really, like I said, a chill weekend. It was just what I needed to like, to kind of disconnect from all the things, not think about all of the various things stressing me out with repro right now. Did some reading, did some baking, snuggled with the kitties. Like, it was really just a lovely weekend of not going out in the very hot outdoors, which was also lovely. Okay. I think with that we will turn to this week's episode and just a flag, like, we will talk more in depth about the mife case and this Rahimi gun case in episodes coming up. But I wanted to make sure that we talked about the decision as soon as we were able to, but we'll have more on them because there are some nuances, particularly in the mife one that we need to talk about. Okay. With that, let's turn to this week's episode. I'm so excited to have with me today Fabiola De Liban to talk all about Medicaid and sexual and reproductive health and why we need to talk about the two of them together. So with that, let's go to my conversation with Fabiola. Hi Fabiola. Thank you so much for being here today.

Fabiola: Hi Jennie. Thanks for having me.

Jennie: So, before we dig into all the things, would you like to introduce yourself and include your pronouns?

Fabiola: Absolutely. My name is Fabiola Carrion De Liban. I am the Director of Sexual and Reproductive Health at the National Health Law Program. And my pronouns are she/her/ella.

Jennie: Awesome. I am so excited to have you on. It's been a really long time since we've talked about Medicaid on the podcast and it's past time.

Fabiola: Yeah. Thank you so much for having me. I love to talk about Medicaid. I love to nerd out and I'm looking forward to your questions and our conversation.

Jennie: So, I feel like before we dig into, like, why sexual and reproductive health and Medicaid and all the like details, maybe we need to take a step back and start with like, what is Medicaid?

Fabiola: Yeah. Medicaid has existed for almost 60 years. It is the largest public health insurance program for low-income people in the United States. And the way that it works is as a federal state partnership. So, the federal program provides some amount of money for the states per service, and then the state gives at least half or even less than half of the amount for every service that is covered by Medicaid.

Jennie: That's so great. I think people, there's a lot of confusion around that. Like, you have Medicaid and Medicare and, like, how are they different? And like I think people don't not necessarily know how they're different or, like, get confused, like, with the Affordable Care Act and stuff. And I think there are so many different things that sound similar but are different that it's worth kind of digging into that a bit.

Fabiola: Yeah, it is so much. So, Medicare is a purely federal-run program. Medicaid is a state federal partnership and that means that it's really complicated because if you know Medicaid in one state, you just know Medicaid in that one state. It's very different across the board. Here in California, the Medicaid program is very different from New Mexico, even from New York, from Texas, from Mississippi—it's just really all over the place. And that's what makes sometimes Medicare great, but sometimes Medicaid really confusing and bureaucratic.

Jennie: Yeah, I'm so glad we were able to kind of clarify that a little bit 'cause it really, it does vary so much state by state. One of the things we do is a 50-state report card that looks at sexual reproductive health and rights at the state level. And one of those things we look at is like Medicaid and like if this, if states have expanded their program, like, they were able to under the Affordable Care Act and like even there you just see such huge variety of, like, what states are doing and how many people are being left behind.

Fabiola: Yeah, I'm really glad that you raised that because historically before the Affordable Care Act, it was not enough to just be low-income or poor. You either had to be pregnant or you had to be a minor or you have to have a disability, or you have to be old. And thanks to the Affordable Care Act, we created Medicaid expansion, which allows someone who is not pregnant or who doesn't have a child or doesn't have a disability to be able to qualify to the Medicaid program. Now when the Affordable Care Act was passed, it was supposed to extend this great new category for all states, and of course, you know, which states sued the federal government and said, no, we don't want healthcare for low-income individuals, so therefore they made it optional. And at the beginning there were about more than half of states who opted to expand Medicaid. And little by little other states have realized that actually it's really good because one of the things that the Affordable Care Act said is actually the state is only gonna be able to cover10% and the federal government picks up 90% of that healthcare service. So, now I'm pleased to say that only nine states have not expanded Medicaid and there's definitely conversations in the works in some of the states where Medicaid has not expanded.

Jennie: That's so amazing.

Fabiola: One important thing...it is so wonderful. One of the things that I wanna highlight is that one out of five Americans are in the Medicaid program. I used to be in the Medicaid program. We believe at the National Health Law program that Medicaid saves lives. There are 77 million people who are on Medicaid and without Medicaid, people wouldn't frankly be able to live or to operate as human beings. So, it is absolutely critical to make sure that it's working and I'm happy to talk to you more about some of the complications which we know exist.

Jennie: So yeah, how does this relate to sexual and reproductive health?

Fabiola: Yeah, so Medicaid is actually a critical payer of sexual and reproductive healthcare services for the most part, and I'll talk about the Hyde Amendment in a little bit, but in regards, for instance, to family planning, Medicaid is the largest public payer of family planning covering 75% of all public expenditures on family planning. Medicaid is the largest single payer of pregnancy services covering almost half of US births, and that includes prenatal, labor, delivery, postpartum. Medicaid also covers outpatient prescription drugs and sterilization and breast cancer services, and some gender-affirming care and mental health and all of the things that relate to sexual and reproductive health. But the one thing that we know Medicaid does not cover is abortion. Shortly after Roe v. Wade was held by the US Supreme Court, so many of your listeners I'm sure know, a congressman by the name of Henry Hyde wanted to get rid of abortion access. And essentially, he knew that the first thing to do was to get rid of Medicaid coverage of abortion services. I'll paraphrase here, he said something like, I would for sure like to get rid of all abortions, but I know that the one way in which we can do that significantly is by running a Medicaid bill. So, since 1977, what we call the Hyde amendment bans Medicaid coverage of abortions with very limited, just with very few exceptions—rape, incest, and life endangerment. And as a result, a lot of people, I would say the majority or at least half of abortion patients, don't have their abortions covered because there is this prohibition. Now there are 17 states that use their own funds to cover abortions for their Medicaid beneficiaries. So not all is lost, however, this is absolutely huge.

Jennie: Yeah. So, as a DC resident, like, definitely expressed my frustration as DC has tried so many times to expand coverage for Medicaid and abortion and Congress keeps blocking it. So, very frustrating.

Fabiola: Yeah, it's absolutely awful. And it's not only frustrating, but it really has endangered people. Since the Hyde amendment was passed, only months later, a Latina woman by the name of Rosie Jimenez lost her life because she couldn't, she was a Medicaid recipient, she wanted to get an abortion. She was a single mother, she was a part-time worker. She was a student, and unfortunately, she had to get an unsafe abortion that ended her life. So, it is no exaggeration to say that the Hyde Amendment is more than frustrating.

Jennie: Yeah.

Fabiola: It's cruel. It is a danger to people's lives, and it has been for many years.

Jennie: Yeah, it just makes me think of like all of the people who could be able to access care, who are being blocked from it, who are having to go to abortion funds, which I mean thankfully are there, but like abortion funds shouldn't have to cover them because they should have coverage and then abortion funds would be able to fund other people who were needing access. Like, it's just like trying to fill in these stop gaps to ensure that people can get the basic healthcare they need.

Fabiola: Absolutely. Thank goodness for abortion funds. They do really the work that's really needed, but they shouldn't have to be. You're absolutely right. I mean, just do the math. If half of US births are covered by Medicaid, then if the Hyde amendment didn't exist, it would cover at the very least half of US abortions and, and the other side knows that really well. So yeah, it's just really unfortunate, especially I think it's cruel to someone who's poor, someone who has children. I mean, you should get an abortion regardless of the circumstances, but it's particularly dangerous to prohibit the coverage of a healthcare service that used to be covered just like anything else once Roe v. Wade was held. And yeah, just to have this barrier is just really awful and it's just really cruel. And this has been happening for almost, I don't know, 50 years and the situation was even bad before the Dobbs decision. So yeah, there was definitely a lot of work to do there. I think given that so many of your listeners like myself, our advocates, as we're thinking about how to rebuild from having you know, the no more of the constitutional right to have abortion services, that as we think about our long-term plan, we have to have coverage in the equation. We have to think about those who are at the margins and that includes low-income people in the Medicaid population.

Jennie: So, we talked about Hyde being a challenge. Are there other challenges with sexual reproductive health within Medicaid?

Fabiola: There are so many. Let me first say that, and I'll divide it between the macro and the micro level. So, the macro level, you know, it's capitalism, it's white supremacy, it's patriarchal systems, structures and attitudes, right? These are all impacting the Medicaid program. It's a shame that we are a quote unquote "developed country" and we have no universal healthcare coverage. So that's a huge issue. Now to talk about Medicaid at large, it's a shame that Medicaid does not cover undocumented immigrants. It's a failure of the Medicaid program. We'll be the first ones to recognize that. It's terrible that there is a five-year bar for even qualified immigrants. So, once you have your documented status, you have to wait five years in order to qualify for Medicaid. We talked about nine states that have not expanded Medicaid, and that really costs people's lives, not only because of the abortion bans, but just in other ways. A lot of people have heard of reimbursement rates...and not just heard, I mean, it's the reality reimbursement rates are really low in Medicaid, which really discourages providers from enrolling in the Medicaid program. Like we said before, Medicaid is extremely bureaucratic because what happens in one state doesn't mean that it's the same in another state. And then it's really difficult for a person to enroll and get the services and call the provider. It's just a big ordeal. It's a big ordeal for someone who…like us are privileged and could maybe have the time to call a provider and find out what our rights are. Imagine someone that doesn't have the privilege that we have, that doesn't have the time that's working part-time jobs that don't have paid sick leave. It's a whole ordeal for them. And then also I think because there is a patchwork of Medicaid coverage even among one state, because even in my home state for instance, the way that the medical program is run by counties, so what happens in LA County is very different from what happens in Fresno. It's just very bureaucratic. And so, it's bureaucratic- in particular, the people that we focus on and my organization are low-income individuals. So, it's just really hard and, you know, put yourself into the shoes of someone who is really busy, who has to tend to other people who perhaps doesn't speak English, who doesn't understand all of the paperwork that they received if they get it. So, certainly there are a lot of problems at the macro level of Medicaid. On sexual and reproductive health, we talked about the hot amendment, we talked about how it has cost people lives even months after it was passed. The Hyde Amendment forces one out of four pregnancy capable people from having the abortion that they want. I should also be remiss if I don't acknowledge the very, I'm just gonna say it, like, bad, horrible, cruel history of Medicaid forcing some people to get LARCs, right, especially in the south or especially with Black folks and folks with disabilities. I wanna recognize that the history has not been great on Medicaid and sexual reproductive health. And so, that's something that we really need to fix. And unfortunately there was just a bill in Indiana that was quote unquote "heavily encouraging" Medicaid enrollers who had just given birth to access long-acting reversible contraceptive. So, it's a history that's not, that just continues to happen.

Jennie: Not actually history?

Fabiola: Exactly, not a history. And so, Medicaid is not fully covering assisted reproduction, which is something that we're also advocating for, gender affirming care—the same trends that we're seeing in terms of bans on abortion and gender affirming care are becoming manifested in the Medicaid program. One thing that's really exciting, and that's also a barrier in Medicaid is the release of the new over the counter birth control pill, which is so wonderful. And so, we want Medicaid to cover that. Nevertheless, Medicaid requires a prescription in order to cover every drug. So that's something that my organization is working on. So, there are again, this huge issue, systematic issues. There are anti issues that are happening and there are some bureaucratic issues. So certainly, there is a lot of work for my organization to do and others in the movement.

Jennie: Now. I feel like I've been hearing there's a lot of new things happening around Medicaid, some good, some bad, but like what are some of the latest trends—if that's quite the right word—that we're seeing around Medicaid?

Fabiola: I'll tell you about some of the positive ones.

Jennie: Yay!

Fabiola: Yay! So, I mentioned, I mean Medicaid is for the most part pretty wonderful in covering maternity care, covers prenatal labor and delivery postpartum. Historically, Medicaid has covered, I won't bore you with the math, but about a little bit over two months of postpartum services. Thanks to a relatively new law, now there is postpartum coverage for up to a year. So now, 45 states are covering postpartum services to people who had just given birth. And that's really great because in particular when it comes to mental healthcare, a lot of the issues arise in the one-year mark, and so that's gonna be really great. In terms of addressing a lot of the maternal mortality and morbidity issues that we're seeing in this country, as I'm sure you and your listeners know, we have one of the worst maternal mortality rates in developed nations. Black and indigenous women have three to four times maternal mortality and morbidity rates than white women. So there, that's something that's gonna be addressed.

Jennie: I have to say. I was, so we added the maternal health expansion to the report card that I mentioned this year, and I was so pleasantly shocked when it was like almost all of the states had done it, like, after seeing like all the fights over like Medicaid expansion and all these other things, but like to see that that was taken up so quickly.

Fabiola: Yes.

Jennie: I was so pleasantly shocked.

Fabiola: Yes. No, it's really wonderful. And with all the states and everyone seems to be on board, so yeah, it's great. I'm glad that your report noted that. A couple of good news on Medicaid and abortion. 17 states used their own funds to cover abortion for Medicaid recipients. Two new states might be covering abortion for their Medicaid recipients.

Jennie: Wooo!

Fabiola: That's Nevada and hopefully Delaware. So, that's progress. One of the trends that's happening is also telehealth delivery of medication abortion. So, as you know, more than half of abortions are abortions that are offered through medications. One out of five abortions are delivered via telehealth delivery. And so now we're also seeing not only a rise in tele abortions or what we call TEMA, but also some of the states that are covering Medicaid abortions for their Medicaid enrollees also covering TEMA, which is really, really great. The other thing that's expanding on the telehealth, I'm sorry, on the Medicaid front, is pharmacy prescription and making sure that more pharmacists are being able to prescribe as well as have those prescriptions of family planning services and contraceptives happen by pharmacies. And so, we see a lot of really great stuff on that. And then the last thing that's, like, really great is doula services. So, more and more states are paying doulas in the Medicaid program to be able to facilitate care for low-income folks, which is really wonderful.

Jennie: That's so awesome.

Fabiola: It is really great. So, 43 states are in the process of implementing or about to implement or have something akin to Medicaid coverage of doula services. And I think that that's gonna be really wonderful, including for low-income folks. I myself used a doula and she was extremely helpful in helping me prepare both for my pregnancy as well as for labor and delivery. And I'm just so excited that other low-income women and pregnancy capable people will also have to do that. One thing that I wanna point out, which I didn't before, is that communities of color are heavily represented in the Medicaid program. And so, if we wanna look at things from the equity perspective and really address the white supremacist issues that are happening in this country, we, again, we have to look at the Medicaid program. So, that's happening in terms of the positive trends, in terms of the negative trends, I mentioned that Indiana bill and I'm wondering whether that's gonna be replicated elsewhere. There's like very air quotes, "heavily encouragement" on using LARCs on certain types of contraceptives for Medicaid recipients. We're definitely scared of any attacks on family planning and Medicaid. We haven't seen any major trends there, but the fact that it happened in Indiana just really gives us pause. The other situation, which I think I also highlighted earlier, was gender affirming care. So, Medicaid could cover gender-affirming care. There are states that are actually requiring the coverage of gender-affirming care. The thing is that gender-affirming care can be different things. It can be hormonal therapy, it can be mental health, it could be gender-affirming surgery. So, it's just a lot of different components that really depend on certain folks. And so, what we're seeing a lot is that some states, when they're banning gender-affirming care, they're also banning gender-affirming care coverage. And the last thing that we're seeing, which has been happening for a while, but I see like a little bit of an uptick lately, is the move from some states to ban abortion providers from the Medicaid program, even if they don't cover abortions, right? Like, in states like Texas, right? Like, abortion providers and in states like Arkansas, they cannot just even be able to provide family planning services covered by Medicaid simply because they also provide abortions. And so, we really need to be careful with that. And there is currently a circuit split on that but hopefully it won't go up to the Supreme Court, but that's something to be watching over.

Jennie: Yeah, and I think just to, like, put a fine point on like why that is so problematic, if it doesn't, isn't apparent to y'all immediately is like those are the places where people are going to go to get reproductive healthcare. Not just who they trust, but, like, where they can get appointments, right? So, for other groups to pick up that load, a lot of times, like a lot of OB/GYNs don't necessarily take Medicaid coverage. Like, it means these people may not be able to access the family planning and reproductive healthcare that they would normally be getting if they were able to go to those clinics that were also providing abortion.

Fabiola: Yeah, the situation is already really bad in those places. Sometimes these clinics are the only places that they can go to to just receive any type of healthcare, any type of screening. And so, if you, I mean you're cutting the very little that some of these folks have in rural communities in places in the South, even in some states...yeah, I mean in vast states like, like Texas, which is huge. Yeah. It would, things will certainly be worse.

Jennie: Okay. So that's like a little bit of doom and gloom. Let’s…I like we were positive before. Opportunities. What are some opportunities to improve Medicaid? Like we've talked about, like the new maternal health stuff was super exciting. Like what, what are some other opportunities?

Fabiola: Yeah, just so amazing and continue to push for doula care and yeah, just continue. I mean it's not, obviously we need to work on universal healthcare. Obviously, we need to get rid of the Hyde amendment, but we can also do some really good things at the state level. And so, let's not, you know, forget that. I think some of the opportunities frankly is about implementation. Medicaid for the most part—with putting abortion aside—does a pretty good job about covering family planning services and maternity care and sexual health and screening. And so, I think frankly one of the biggest opportunities is getting to know what Medicaid covers in your state and making sure that it's being implemented. And I'm just so thrilled to be in this space so that hopefully your listeners can go and read up on Medicaid or figure out if they're on Medicaid. Some people don't even know that they're on Medicaid. So, there is a lot of potential for knowledge and for just implementation. The other opportunity is section 50 57 of the Affordable Care Act. This is the first civil rights law to prohibit sex discrimination, it prohibits in a healthcare setting. So, it prohibits discrimination on the basis of sex, race, color, national origin and disability. And it bans these types of discrimination in healthcare programs, including health plans and providers, anyone that receives federal assistance, which is Medicaid. So, I think that there is an opportunity to make sure that you are not being discriminated by a provider or a health plan that covers- that receives Medicaid funds. And now, HHS, the US Department of Health and Human Services, released a new regulation on section 50 57 really encouraging people to make sure that they're not being discriminated based on sex, which includes pregnancy-related services, which includes potentially abortion, gender reaffirming care, all of these things, and has created a mechanism so that patients can file complaints or raise issues before HHS directly. So, we think that there is a lot of potential there to at least sound the alarm whenever they're being discriminated. The other opportunity that there is now that's gonna be implemented in 2026 is this new entity called the Medicaid Advisory Committee and the Beneficiary Advisory Council. So, family planning providers or patients can be in their state advisory committees or beneficiary advisory councils to make sure that they have an influence in their state Medicaid program. So, you can certainly definitely check out what your state is doing. Obviously look at our website, look at HHS's website to figure out how they can be included. And so hopefully, even if they don't participate, I think that there is a lot of potential for providers including family planning providers and for all the providers out there, I hope that you get involved as well as for former or current Medicaid beneficiaries to really be able to be involved in the making of Medicaid policy. So that's really exciting. Again, we talked about maternity care, making sure that all is being implemented when it comes to postpartum family planning services. I think that there's also an opportunity with this program within Medicaid called presumptive eligibility. So, presumptive eligibility happens when someone doesn't have Medicaid but they qualify for it and they go to a provider and essentially sign up at the same time that they're getting the Medicaid service. So, I go to an abortion provider in California and that abortion provider, but I don't have Medicaid, but I would've qualified. So I say I want to have my abortion coverage today, but I'm not on Medicaid. So, that presumptive eligibility provider signs me up right there, it starts the enrollment process, and I can get the service right there. So, we've been encouraging as many providers, abortion providers and reproductive health providers in the states that cover Medicaid to become perceptive eligibility providers. And if they can, the other thing that I think that needs to be really implemented is the service under Medicaid called the Non-Emergency Medical Transportation. So, Medicaid is actually supposed to cover for transportation, meals and lodging, and expenses of attendance if you need someone to go with you to your appointment if the service is covered by Medicaid. So again, there are all of these opportunities that exist within the Medicaid program that people don't know about it. I will be the first one to admit that they're really complicated. I'll be the first one to admit that it doesn't, they don't work, like, seamlessly. But certainly I think that if more people are utilizing the services, there is definitely a potential to make them better and to hold providers, healthcare plans, everyone accountable in providing the service that they are entitled to provide or required to provide.

Jennie: That's so great. I love ending with, like, opportunities of where things can get better. That's so exciting. Okay. But my other favorite way to end is how we end all of our episodes and that is like what can our audience do? Like, how can our audience get involved to make things better?

Fabiola: Yeah, I, all the things that I mentioned before, I would say obviously people say vote, get involved with your state and federal policies and that is all great, but there is something that I know everybody can do. And to become educated about your own healthcare coverage, whether you're on Medicaid or not, you are entitled to receive information about your coverage. You're supposed to get this document called the summary of Benefits and Evidence of coverage. And so, become educated, a lot of healthcare plans don't offer that. So, make sure that you are requesting that. I'm not gonna bore you with the intricacies of it, but a lot of Medicaid recipients are, in fact 73% of them, are in the system called Medicaid-managed care, which means that they are enrolled in a healthcare plan and then the healthcare plan is involved in the Medicaid program. So, those healthcare plans are supposed to inform you, they have the requirements to give you the opportunity to appeal. So yeah, your listeners, we should all be looking at our coverage documents and then talking to our relatives, talking to our friends, like what does your plan cover? So, that's the one thing. The other thing that I would say is to become educated on Medicaid. Just generally, you can go on our website at healthlaw.org. There are so many other organizations. Abortion funds are absolutely wonderful in also providing a lot of information on Medicaid. It goes without saying, please support your abortion fund, please donate all the things that you always encourage in your podcast, Jennie. Medicaid agencies also have a lot of powers, so checking them out. If you go to CMS, the Centers for Medicare and Medicaid Services, they have a list of all the Medicaid agencies and then what I mentioned before, the Medicaid advisory committees and beneficiary advisory council. That's gonna be an incredible opportunity for everyone in this podcast to have a voice in terms of making some real change when it comes to their state Medicaid programs.

Jennie: I think the only thing that I would add is to reach out to your Congressperson and tell them to get rid of Hyde.

Fabiola: Oh, a hundred percent.

Jennie: And to support the EACH Act.

Fabiola: Absolutely. Get rid of the Hyde Amendment. EACH Act. Oh yeah. There are so many other bills, which is so exciting that are happening at the federal level. Yes, absolutely.

Jennie: Obviously see what your state is doing and how they can be better because you know, those, those exceptions that exist that you know, are at the federal level just because they exist, like we've seen right now, right. When we've talked about exceptions for accessing abortion in states where it's banned, they are not always easy to do. So, like, making it easier in your state would be great.

Fabiola: Yeah, absolutely. So, I think I should emphasize again, the exceptions are rape, incest, and life endangerment, just so that you know, Medicaid law, while some states might have a rape reporting requirement, Medicaid law, the federal Medicaid law requires states to have a waiver in the event that that person doesn't feel comfortable reporting that rape. So, certainly making sure that that's being enforced is absolutely critical.

Jennie: That's really great. Thanks for lifting that up.

Fabiola: Of course.

Jennie: Well, Fabiola, it was so lovely to talk to you today. Thank you so much for being on the podcast.

Fabiola: It was so wonderful being here, Jennie. Thank you so much for having me.

Jennie: Okay y'all, I hope you enjoyed my conversation with Fabiola. I had so much fun talking to her and learning all about Medicaid and why we need to be thinking about sexual and reproductive health and Medicaid together. And with that, I will see y'all next week. [music outro]

Jennie: If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprofightback.com. Thanks all!