Prevention First Initiatives
in the State Budget


The state budget, now signed into law, contains important provisions that enhance women’s health, protect critical health care services like cervical cancer prevention and save the state, employers and families money. These prevention first initiatives include Contraceptive Equity, Prescription Protection, and expansion of the Family Planning Waiver.

6/29/09 - Governor Doyle Signed State Budget & Prevention First into Law!

On June 29, Governor Doyle signed the state budget and the 3 prevention first initiatives into law: Contraceptive Equity, Prescription Protection, and expansion of the Family Planning Waiver! Read the full News Release

6/17/09 - Senate Passes State Budget & Prevention First!

On June 17, the Senate passed the state budget and the 3 prevention first initiatives!

6/13/09 - Assembly Passes State Budget & Prevention First!

On June 13, the Assembly passed the state budget and the 3 prevention first initiatives!

Contraceptive Equity

The budget contains provisions that require all insurance policies that contain a prescription drug benefit to cover prescription contraceptives.

• This provision ensures fair insurance coverage must include health care women need everyday. As a matter of basic fairness, prescription drug plans should cover prescription birth control methods.

• Birth control is basic health care, used by over 95% of women at some point in their lives. Excluding birth control coverage under prescription drug plans discriminates against women.

• The state legislature sometimes has a duty to ensure that insurance plans are fair. This has led to passage of legislation requiring coverage of mammograms, maternity and newborn care and access to an obstetrician or gynecologist.

Requiring insurance plans to cover birth control prescriptions does not increase the price of premiums for employers. In fact, including coverage actually saves money.

• The State of Wisconsin currently provides health insurance plans that cover prescription birth control. In addition, since 1999 the federal government has required all health benefits plans to cover birth control prescriptions. Neither has seen an increase in costs as a result.

• The National Business Group on Health, an organization representing over 160 large national and multinational companies, found that failing to provide contraceptive coverage actually costs employer 15-17% more than actually providing it (Family Health in Brief, Washington Business Group on Health, 2000). Birth control is the best prevention investment an employer can make. Direct costs related to childbirth are some of employers’ highest health care expenditures.

• Government also saves taxpayer dollars —a recent study shows that for every $1 spent on birth control services under the Medicaid program, federal and state governments save $4.02 (the Guttmacher Institute, 2008).

Prescription Protection

The budget contains provisions to make sure no woman is ever abandoned at the pharmacy counter. Prescription Protection requires that all pharmacies have someone available during business hours to dispense safe, legal birth control prescriptions.

• Pharmacies must ensure that patients receive their birth control without discrimination or unnecessary delay.

• Given the barriers women face in accessing health care and the cost of unintended pregnancy on the state (each Medicaid birth costs $10,000 as compared to $300 for annual contraceptive drugs and supplies), we need to do everything we can to dismantle these obstacles and make sure women have access to the health care they need, including birth control.

• In Wisconsin, many women live in rural parts of the state where the next pharmacy may be miles away. It is unconscionable to expect a woman to drive all around the state just to access her doctor prescribed medication!

• Birth control is basic health care. Prescription birth control pills are often used not just to prevent pregnancy but to treat serious medical conditions like endometriosis and infertility.

• According to a 2007 Mellman poll, 84% of Wisconsin voters believe that pharmacies should ensure all women have access to birth control prescriptions.

Family Planning Waiver

The expansion of the Family Planning Waiver includes providing family planning health care such as sexually transmitted infections testing and treatment for low-income men.

• Publicly-funded family planning services provide critical health care to low-income women, men and teens, including cancer screenings, breast exams, STI testing and treatment, and access to birth control.

• For each $1.00 spent on family planning services, $4.02 is saved by preventing unintended pregnancies and providing preventive health care. Since 2003 when the Family Planning Waiver was implemented, it has saved the state $487 million.

Why Do We Need These State Protections for Women’s Health?

1) Women face many barriers when trying to obtain health care. In fact, recent reports highlight just how difficult it is for women to obtain basic prevention health care.

• 7 out of 10 women surveyed were either uninsured, underinsured, reported medical debt problems or experienced a cost related problem accessing health care (Women at Risk: Why Many Women Are Forgoing Needed Health Care, the Commonwealth Fund, May 2009).

• 52% of women report delaying care because of costs, compared to only 39% of men (Commonwealth Fund, 2009).

• Women pay 68% more out-of-pocket health care costs than men, in part because women must pay for contraceptives (National Women’s Law Center, 2001).

• Women have more medical debt than men, with 45% of women saying that they had problems paying off medical expenses last year (Commonwealth Fund, 2009).

2) Birth control is basic health care for women for over 30 years of their lives.

• 40% of women who are at risk for an unintended pregnancy say they have problems accessing birth control.

• If we allow insurance plans to exclude birth control or pharmacists to refuse to fill doctor prescribed birth control prescriptions, we are contributing the cycle of unintended pregnancy and poverty that plagues primarily women and children in our state.

Supporting Family Planning is Cost-Effective

  • Governor Doyle’s budget supports and maintains family planning funding under the Medicaid program.
  • Funding family planning services is the single most cost effective investment that the states and the federal government can make in preventative health care.
  • The state saves $4.02 for every $1 it spends on family planning care (The Guttmacher Institute).
  • According to the WI Department of Health Service’s 2008 evaluation, the Medicaid Family Planning Waiver program has saved the state $487 million dollars since 2003.
  • Governor Doyle’s budget also expands the Medicaid Family Planning program to young men ages 15-44, a wise investment during times of economic hardship.
  • Making men eligible for this preventative program provides cost savings by reducing unintended pregnancies and births, and the incidence of STIs.
  • During the first year of serving men under the program, DHS estimates that Wisconsin would save over $585,300.
  • The Federal Government assumes 90% of all Medicaid Family Planning costs.
  • During the last two years, the state received approximately $59 million in federal dollars for family planning services.