Goals and Priorities of Community Members Regarding the Federally Mandated Medicaid Sterilization Policy.

Abstract

To describe the opinions of community members who are potentially eligible for Medicaid insurance regarding the 30-day sterilization waiting period. This mixed-methods study consisted of 10 informed deliberation sessions with 85 Michigan residents with low income (aged 21-51 years) between April and June 2024 to explore and describe their thoughts about the waiting period and suggested revisions to the policy. The deliberation sessions included policy education, expert questions and answers, facilitator-led discussion, and a small-group exercise on potential policy options. Participants completed presurveys and postsurveys measuring knowledge and opinions about contraception and the Medicaid sterilization policy and validated scales regarding contraceptive autonomy, health care experience, and discrimination. Deliberators favored replacing the current policy with a revised policy that includes a reduced or eliminated waiting period that applies to all individuals, not solely to those with Medicaid insurance. They also recommended revising the informed consent process for clarity, accessibility, openness to discussion, and timeliness. Groups with low income who engaged in informed deliberations recommended replacing the current policy, indicating that the policy does not serve the goals of the communities most affected.