Birth control pills. A nonprofit group's new scorecard assesses how state policies affect access and availability for contraception. (Getty Images)

For Wisconsinites who care about access to birth control, a new scorecard published Wednesday offers a mix of good and bad news.

On the plus side, Wisconsin’s Medicaid program covers the cost of contraception for people with incomes up to just over 300% of the federal poverty line, according to the Population Reference Bureau. State law also requires insurers to cover the cost of prescription contraceptives.

On the down side, Wisconsin law allows health insurance plans to require a patient co-payment, the Population Reference Bureau reports. And the state also hasn’t enacted legislation that allows more health care professionals to issue birth control prescriptions.

The Population Reference Bureau is a nonprofit, nonpartisan policy and research organization that describes its mission as improving people’s health and well-being through policies and practices rooted in scientific evidence.

Wednesday the bureau published its first-ever scorecard assessing contraceptive access for all 50 states and the District of Columbia.

Reviewing a collection of policies that address affordability,  availability and the environment of health care, the scorecard rates each state as protective, restrictive or mixed on contraception access. 

“Nearly 35% of Americans or 121 million people currently live in a state that actively restricts access to contraception through their policies,” said Cathryn Streifel, senior program director for the organization, in a briefing for reporters Tuesday. “This patchwork of policies creates a system where reproductive health care access depends on where you live.”

Broad access to contraception “is essential to helping people live with more freedom, health and possibility,” Streifel said — allowing people to have reproductive autonomy, making it possible for them to complete education and join the workforce, and contributing to economic stability. Contraception also reduces the risks for maternal and infant mortality and helps reduce public health costs, she added.

“We are at a moment where understanding state policy landscapes matters more than ever, because state policies are really shaping the reality of contraceptive access on the ground — especially because the federal protections are crumbling,” Streifel said.

Christine Power, a senior policy advisor with the organization, said the scorecard can help policymakers, advocates and the general public understand where each state stands.

The goal is “to ensure that this contraceptive policy is more transparent and actionable and to highlight both progress and gaps in access across the country,” Power said.

The scorecard rates 16 states and D.C. as protective for contraception access and 16 as restrictive. Wisconsin is one of 18 states with a mixed scorecard.

Wisconsin’s protective policies include the Medicaid coverage for family planning services. In addition, the state requires that hospital emergency rooms provide access to emergency contraception.

Wisconsin’s laws on sex education get a mixed rating. Positive points include  requiring medically accurate curricula, not requiring parental consent and not limiting sex ed to abstinence only. On the negative side, school districts are not required to offer sex ed.

The scorecard rates the state’s failure to fully expand Medicaid under the Affordable Care Act as restrictive, along with the failure to expand contraceptive prescription authority to more health providers. A bill that would allow pharmacists to prescribe birth control pills has passed the Wisconsin Assembly and is awaiting a vote in the state Senate.

On several other issues that the scorecard includes, Wisconsin has no policy.

The state doesn’t require insurers to cover an extended supply of contraceptives beyond three months, which increases a state’s score for being protective. Wisconsin also has no policies explicitly allowing minors to independently access contraceptive services or restricting them from doing so.

“Ten states restrict most minors from independently accessing contraceptive services,” said Power. “This policy creates additional hurdles for young people seeking to make informed decisions about their reproductive health, potentially leading to delayed care, unintended pregnancies, and negative long-term health outcomes.”

Wisconsin law is silent on whether health care providers or facilities can refuse to provide contraceptive services on religious or moral grounds. In other states, laws permitting that refusal are rated as restrictive.

The scorecard doesn’t rank the 50 states, but it does single out those with the highest scores for protection as well as those with the most restrictive policy framework.

Washington and California are the two states with the most protective contraception policies, Power said, while Kansas had the lowest score, with a mix of restrictive policies and the absence of any policy.