Expanding Access & Improving Health Outcomes: Contraception and Maternal Mental Health
The foundations of health and well-being begin in our homes, schools, neighborhoods, and workplaces. But these places also often harbor inequities that impact the health of women, girls, and gender-expansive people in our society.
To thrive, Minnesota’s women and girls need accessible affordable, and culturally competent health care. Our 2024 Status of Women & Girls+ in Minnesota, produced in collaboration with the Center on Women, Gender, & Public Policy at the Humphrey School, states that reducing health disparities and increasing positive health outcomes for all Minnesotans requires economic opportunity, physical activity, access to affordable and healthy foods, safe housing and neighborhoods, mental health services, and policies that ensure affordable access to high-quality health care. Health inequities for Black, Indigenous, and women and girls+ of color, LGBTQ+ people, and rural and girls+ lead to significant differences in health care access, quality, and outcomes in Minnesota.
The Women’s Foundation believes that Minnesotans should have access to the services required to support healthcare decisions for themselves and their families. Our 2025 policy agenda includes bills to expand access to contraception through broader insurance coverage for over-the-counter and prescription contraceptive methods and vasectomies across Minnesota, and improve pregnancy health outcomes by mandating health plans cover for maternal mental health screenings and the psychological collaborative care model.
Insurance Coverage for Contraception & Vasectomies
Requiring vasectomies and over-the-counter contraceptives without a prescription to be covered at no cost is not just about expanding access to a medical procedure; it’s about closing a glaring gap in our healthcare system.
Vasectomies are a procedure that often gets overlooked in health discussions, despite being a safe, permanent, effective, and minimally invasive procedure. The imbalance of this discussion sends an outdated message that contraception is solely a woman’s responsibility.
This antiquated idea means women often bear the physical, emotional, and financial burden of contraception, from pills and IUDs to surgery. However, women in our state also face access barriers for even those options. In our biennial Status of Women & Girls+ report, we found that in 2022, about 12% of Minnesota women — 283,000 — resided in a contraceptive desert, where they lack sufficient access to health centers offering a comprehensive range of contraceptive methods.
Fully covering vasectomies (HF 774/SF 1054) helps redistribute that responsibility, providing balance in healthcare, empowering men to make responsible choices and supporting women who may face side effects, health risks, or access barriers to hormonal birth control or tubal ligations. From a fiscal standpoint, vasectomies are a cost-effective solution. A one-time, outpatient procedure is significantly less expensive than long-term contraceptive methods.
Additionally, for the nine in 10 females who use or have used contraception as birth control to treat endometriosis and fibroids and to help regulate periods, and for those who choose condoms for safety and pregnancy prevention, birth control is essential health care. Covering over-the-counter contraceptives including condoms, spermicide, Plan B, and the OPill, as proposed by HF 1485/SF 1752, will ensure that people of all economic backgrounds have access to birth control, and the power to make the decisions that are best for their body and future. Studies consistently show that investing in health solutions like these leads to long-term savings for health care systems.
By passing bill SF 1054, and SF 1752 Minnesota would join other states who believe in equitable health care. It’s a matter of fairness, fiscal responsibility, public health and personal freedom
Insurance Coverage for Maternal Mental Health
The Status of Women & Girls+ in Minnesota includes startling statistics that reveal a mental health crisis for women and girls, across age groups, in Minnesota. In July of 2023, 27 percent of Minnesotan women reported symptoms of an anxiety or depressive disorder. Alarmingly, 60 percent of ninth-grade girls have seriously considered attempting suicide while two-thirds of college women in our state have reported a mental health diagnosis in their lives, and 18 percent of women 65 and older have reported depressive symptoms.
Pregnancy and new parenthood can be a time of beauty and stress, joy and pain, personal growth and stifling isolation. And yet, an estimated 75% of women impacted by a maternal mental health disorder do not receive the treatment they need.
Minnesota’s Department of Health Maternal Mortality Update found that 20% of maternal deaths between 2017-2019 were caused by mental health conditions. The same report notes that mental health issues (including substance use disorders) as a cause of pregnancy-associated fatalities have risen when compared to other prevalent causes of death.
According to the Maternal Mental Health Leadership Alliance, maternal mental health conditions are the most common pregnancy and childbirth complication. Whether you know it or not, someone in your life has struggled with their mental health during or after their pregnancy.
HF 35/SF 1085 would require health plans, to establish Maternal Mental Health Programs, to expand screenings, align with HEDIS quality measures, provide provider training, and create a centralized referral network. By streamlining care and reducing provider burden, this initiative will help more mothers access the critical support they need. By requiring screenings as a routine part of perinatal care, it removes the shame and stigma a patient might feel in asking for help and increases the likelihood that emerging issues will be flagged earlier, with lifesaving benefits and savings. When health plans connect providers to resources, it breaks down the access barrier that challenges rural communities, communities of color, and those living in poverty.
Another bill in mental health care, SF 8/HF 958, would provide medical assistance coverage of the psychiatric collaborative care model.
The collaborative care model would bring mental health care services into the primary care setting and fully include their primary care physician in care plans. Studies have found that this model can reduce stigma and overall cost of care and lead to faster diagnosis and subsequent treatment of mental health conditions.
Barriers to maternal mental health care still exist. Along with stigma and cost, accessing mental healthcare providers can be incredibly difficult to do on your own. Our 2024 Status of Women and Girls+ report shows that approximately 80% of Minnesota counties have a shortage of mental health professionals.
Path to Progress
In in-person testimony at the Capitol and letters of support, the Women’s Foundation has shared how including essential care like vasectomies, over-the-counter contraception, maternal mental health screenings and the collaborative care model in health coverage equals positive health outcomes for all Minnesota families. Closing gaps in coverage for sexual, reproductive and mental health is a necessary part of valuing women’s healthy and whole lives.
For now, most of these bills have been heard, but were laid over for possible inclusion in the omnibus bill. The maternal mental health bill was passed unanimously and will move on to the Senate Health & Human Services Committee!
What You Can Do
As defined by the World Health Organization, health is not merely the absence of disease or infirmity but must also be inclusive of complete physical, mental and social well-being. We appreciate the work of the authors and the co-authors of these health bills for bringing them forward and for their continued work to create and pursue policies that will make Minnesota safer for women and girls.
Reach out to your elected representatives and ask them to support these bills so that we can get closer to a truly healthy Minnesota.
