Our Partners in Massachusetts
In 2017, NARAL Pro-Choice Massachusetts built on Massachusetts’ status as a model policy lab for health care by successfully advocating for the passage of the ACCESS (Advancing Contraceptive Coverage and Economic Security in our State) bill, which puts in place state-level protections for contraceptive access. Among other provisions, this bill codifies coverage of contraception with no copay into state law; requires insurance coverage without copay or prescription for over-the counter emergency contraception; and limits medical management techniques that pose barriers to contraceptive access.
In 2013, NARAL Pro-Choice Massachusetts strengthened and grew the Mass Women's Health Coalition (MWHC), which monitored implementation of the ACA and Massachusetts cost containment legislation. The organization also submitted recommendations to the Division of Insurance on protecting confidentiality. In 2009, NARAL Pro-Choice Massachusetts launched a citywide coalition in Boston to provide recommendations to the Boston Public Health Commission on adolescent reproductive health. In the 2012-2013 school year, this Coalition led successful advocacy efforts to implement the Boston Public Schools Wellness Policy, a holistic curriculum that includes K-12 comprehensive sex education.
The Pro-Choice Massachusetts Foundation is working to address private and public insurance barriers to offering immediate post-partum LARC placement. This begins with identifying current reimbursement policies for immediate postpartum LARC among private health insurers and using this research to inform advocacy for administrative policy change that will expand coverage of immediate postpartum LARC. Simultaneously, the Pro-Choice Massachusetts Foundation is working with major health care facilities across the state towards implementation of this service. NIRH supports its LARC partners by offering technical assistance as needed, linking their work to state and national trends and best practices, and lifting up their successes and lessons learned to share with the field.
In 2017, Health Care for All (HCFA) launched an advocacy campaign to ensure that patient-provider confidentiality is upheld by health plans in their state with a particular focus on protecting the safety of individuals seeking often-stigmatized care, including reproductive and sexual health, or those living in domestic violence situations. With the Protecting Access to Health Care (PATCH) Alliance, HCFA successfully advocated with the Massachusetts Department of Insurance (DOI) and Department of Public Health for guidance that will ensure that patient confidentiality is protected by insurance companies across the state. In 2018, HCFA will turn their efforts to focus on the successful implementation of the bulletin.
Supported by the National Institute, HCFA and its partners in the Preserving Access to Confidential Health Care Alliance advocated in 2015 for confidentiality protections in health insurance carriers’ summary of payments forms, under development by the Massachusetts Division of Insurance. To secure these essential protections, HCFA worked with lawmakers to introduce Massachusetts Senate Bill 2081, and conducted a robust advocacy campaign to secure support from legislators and stakeholders. The bill passed favorably out of the Health Care Financing Committee before the end of the legislative session. If it is ultimately enacted, strengthened confidentiality measures will be used by all private insurers in Massachusetts, improving access to sensitive health care services for a range of health care consumers.
In 2017, Prison Birth Project (PBP) continued their partnership with the local women’s jail by offering childbirth education and full-spectrum doula support for incarcerated people who are pregnant, using the reproductive justice framework. The organization also raised awareness of the experiences of incarcerated parents through their #MamasDayAcrossBars campaign and developed strategies to share their expertise and lessons learned with organizations that engage in similar work across the country. NIRH is proud to have partnered with PBP since 2014, working on the passage and implementation of Massachusetts’ 2014 anti-shackling policy.
In 2016, Prison Birth Project (Holyoke, MA) continued their advocacy and outreach efforts to advance member leadership and strengthen relationships with allies in the Holyoke community. PBP members presented critical, emotional testimony on their personal experiences with shackling, prompting multiple meetings with members from Attorney General’s office who have promised to advise the Dept. of Corrections to adhere to the statutes. In 2016, PBP sought to recruit new members for their parent leadership and organizing group. After seeing low turnout initially, PBP changed their strategy and recruited in residential programs, where parents are already gathered.
In 2015 the Prison Birth Project, with the support of the National Institute, worked to ensure implementation of a Massachusetts state law that prohibits the shackling of pregnant and incarcerated women through pregnancy, labor, delivery, and recovery including the development of a Know Your Rights campaign for incarcerated women. They also created a pilot organizing group of mothers and trans parents who are formerly incarcerated or at increased risk of incarceration to engage affected community members in stregthening protections for incarcerated people. This project was conducted in partnership with Prisoners' Legal Services, a fellow National Institute partner.
In 2015, Prisoners' Legal Services, with the support of the National Institute, worked to monitor implementation of a state law that prohibits the shackling of pregnant incarcerated women through pregnancy, labor, delivery, and recovery and notified prisons and jails of violations. They also engaged in stakeholder education around the law by creating educational materials for defense attorneys and relevant professional organizations. This project was conducted in partnership with Prison Birth Project, also a National Institute partner.
Incorporating LARC provision into primary care is a core component of improving the delivery of family planning services. Recognizing that not all primary care providers will be able to provide LARCs directly, the Connors Center for Women's Health and Gender Biology at Brigham & Women’s Hospital worked in 2017 to identify challenges in the referral system for LARCs within the hospital's network and to develop an efficient and effective referral process to ensure timely, patient-centered access. Brigham & Women’s Hospital’s extensive network of affiliated community health centers, private clinics, and hospital-based primary care practices provided an opportunity to work with a variety of governance structures, insurance provider systems, and health care delivery models. By identifying and addressing barriers to high-quality LARC referrals within this large and diverse group of primary care providers, this partner could define the elements of high-quality LARC referrals and determine how to create and implement such a system.
Through this project in 2017, Planned Parenthood League of Massachusetts (PPLM) offered etonogestrel hormonal implants at the time of mifepristone administration for women undergoing medical abortion. The project built on PPLM’s participation in a Gynuity Health Projects study that found this procedure was associated with both increased use of highly effective contraceptive methods six months later and increased patient satisfaction. PPLM also developed strategies to overcome anticipated barriers to providing this service, including education of the patient population, receipt of adequate reimbursement, and operational challenges to integrating the procedure within clinical practice.