The federal government, which spends billions of dollars each year covering unintended pregnancies, is encouraging states to adopt policies that might boost the number of Medicaid enrollees who use long-acting, reversible contraceptives (LARC). The federal push reflects the continuing concern over the nation's rate of unintended pregnancies, which is one of the highest among developed countries. In 2010, the federal government spent $14.6 billion and states another $6.4 billion on unplanned pregnancies. Under Medicaid states must cover family planning services for women and men without charge. Although they have latitude in determining which services, they've generally included most methods of birth control, said a senior public policy associate at the Guttmacher Institute. Yet overall adoption of long-acting contraceptives has been slow in state Medicaid programs. In 2012, about 11% of low-income beneficiaries used a LARC, similar to the percentage of U.S. women overall. The Center for American Progress published a study calling for the increased use of LARCs for Medicaid enrollees both right after delivery as well as following abortion. It's one of a growing number of advocates, starting two years ago with the Association of State and Territorial Health Officials and continuing with the National Institute for Children’s Health Quality. A published rule for managed care organizations that run many Medicaid programs also addressed LARCs. It said states must offer enrollees a choice of contraceptive methods and can't require prior authorization or step therapy, said counsel for health and reproductive rights at the National Women's Law Center.