If you live in Kansas, it might be a lot harder to access birth control than it is in other states. New research by the Population Reference Bureau, or PRB, shows that’s because of the state’s policies on contraceptive access.
PRB recently released scorecards on each state, grading them based on whether or not their policies protect access to contraceptives. Kansas ranked dead last.
Christine Power, a senior policy advisor with PRB, said Kansas is one of 16 states with policies that restrict access to contraceptives. For example, Kansas hasn’t expanded Medicaid and the state limits access to birth control in pharmacies.
“Kansas's contraceptive policy environment scores as restrictive on several key policy indicators,” Power said.
Power said another reason Kansas got a low score is because the state has a lot of policy voids, where the state doesn’t restrict access to birth control or contraceptive education, but it doesn’t protect it, either.
What Kansas is doing well
Researchers looked at three main policy areas: affordability, availability and environment of care. Each policy area has three subcategories.
Power said when it comes to accessibility, Kansas allows nurse midwives and nurse practitioners to prescribe contraceptives.
“This really helps break down barriers to access for Kansans seeking care through other types of providers, those who might not have access to a physician,” she said.
Kansas also requires grade schools to teach sex education and does not require parental consent for students to take part in the lessons.
Power said although Kansas has room to improve sex education, it does not require teachers to use an “abstinence only” curriculum that teaches students that the only way to prevent pregnancy or STDs is to abstain from sex outside of marriage.
Where Kansas needs to approve
Cathryn Streifel, a senior program director at PRB, said while it’s a good thing Kansas requires sex education, the state does not require instructors to use a medically accurate curriculum, which could open the door to misinformation.
Streifel said a couple of Kansas’ policies that hurt its score relate to refusal clauses and prescribing authority.
“Kansas policy currently explicitly allows individual providers and pharmacists to refuse to provide contraceptive services if they reasonably believe that a drug or device may result in an abortion,” Streifel said.
Streifel said this jeopardizes access to contraceptives for Kansans. She said Kansas also does not allow pharmacists to prescribe contraceptives.
Another area that brought down the state’s score has to do with affordability. According to the study, Kansas does not have a policy requiring health insurance companies to cover contraceptive costs without cost-sharing. Kansas also has not expanded Medicaid and the state does not have expanded coverage under the Affordable Care Act to cover family planning.
“That is limiting access for many groups with low income who often face those significant financial barriers to care but don't qualify for traditional state-funded programs,” Power said.
Power and Streifel highlighted that Kansas’ lack of policies in important areas, like requiring Medicaid and insurers to cover contraceptives over an extended 12-month period, or policies on providing emergency contraception, also brought the state’s score down.
They want Kansas legislators to consider addressing areas where there is no policy to strengthen access to contraceptives.
“Access to contraception really allows people to plan their pregnancies,” Streifel said. “This leads to higher educational attainment, increased participation in the workforce, lower levels of maternal mortality and morbidity as well as decreased costs for the public health system.”
Bek Shackelford-Nwanganga reports on health care disparities and access for the Kansas News Service. You can email her at r.shackelford@kcur.org.
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