In a new commentary in the journal Health Affairs, UW obstetrician-gynecologists Margaret Harrison and Abigail Cutler consider ways that current Medicaid patient consent requirements can inadvertently work to make tubal ligation less accessible for those who want it. (Dr. Cutler is also a CORE researcher.)
The mandatory Sterilization Consent Form process for Medicaid enrollees was intended to protect members of marginalized communities from being sterilized without informed consent. However, it may unwittingly present barriers to access and reduce reproductive autonomy.
Medicaid rules require patients to sign the consent form in-person at least 30 days before their procedure, which can especially burden those patients who have to travel significant distances to healthcare, such as rural Wisconsinites.
The American College of Obstetricians and Gynecologists and the Society of Family Planning support telemedicine for contraceptive counseling. But those on Medicaid must travel to sign the consent form in person.
Other problems include the form’s lack of readability, especially for those with low health literacy, as well as lack of translation of the form to other languages.
These barriers are compounded by surgeon availability, limited operating rooms/anesthesia, and religiously affiliated hospitals. Researchers estimate that the Sterilization Consent Form leads to many unfilled procedures for Medicaid patients – more than 25% of desired tubal ligations.
By allowing for both telemedicine and electronic signatures for consent, Medicaid could increase reproductive health accessibility and autonomy among the people served by their program.
Read the full piece here.