Of the many open-to-interpretation objectives of the Patient Protection and Affordable Care Act (ACA), the family planning services that are part of “mandatory” benefits have been among the most difficult to pin down. That’s largely because individual states have some leeway in deciding which services should be included as mandatory. At the same time, the several tiers of Medicaid have added to the confusion about what is covered and what isn’t.

To find out what the family services inclusion trend has been among the states, the Kaiser Family Foundation asked the 50 states and the District of Columbia to share their policies on family planning service inclusion. Not everyone responded; but Kaiser did gather data from 41 of the 51 entities.

The survey found that, in general, there was “wide coverage” of basic family planning products and services, particularly “most prescription contraceptives.” However, when asked about emergency contraceptives and other less traditional family planning services, coverage was far more variable. And services that address spousal abuse were apparently not considered to be essential in some states.