Reproductive Health Access Project

Primary care settings, including federally qualified health centers (FQHCs), can play a vital role in providing access to reproductive health care, especially in underserved communities.

In many of the State’s rural areas, FQHCs may be the sole providers of health care and can close reproductive access gaps by providing medication abortion (MAB), a safe and effective option for early-term abortions. A number of barriers impede the delivery of this care: fear of attracting negative attention; misinformation about federal and state rules governing abortions; and navigating administrative logistics. Although New York is one of 16 states where Medicaid covers abortion, there is no mechanism for FQHCs to bill for MAB services outside of their federally approved Medicaid reimbursement rate; therefore, addressing policy and implementation challenges is essential. In 2022, NYHealth awarded the Reproductive Health Access Project (RHAP) a grant to address structural barriers to pave the way for expanded access to more comprehensive reproductive health care services in primary care settings throughout New York State.

Under this grant, RHAP and its partners developed and promoted policy changes that create mechanisms for FQHCs to bill Medicaid for MAB. RHAP also conducted interviews and surveys of FQHCs and primary care organizations to understand current practices and challenges and assess resources, technical assistance, and levels of readiness to offer MAB. In addition, RHAP convened a workgroup of FQHCs and other primary care organizations, including providers that already have successful models as well as those that may be further behind. Finally, RHAP provided technical assistance to help sites with operational issues as they began to integrate MAB into their practices.