A governor's budgetary decisions could, directly and indirectly, affect access to contraception in the state. Maryland, for example, is one of the states that chose to expand Medicaid coverage — and along with it, contraceptive coverage — to more low-income adults through the Affordable Care Act. Maryland's next governor could reverse that decision. Separately, the state funds a pair of family planning programs for low-income women, which collectively will cost about $11.4 million this year. The health department and others have identified other ways the state could improve family planning services, including the integration of family planning and substance abuse treatment, creating a new program targeted at teens and modeled after an effective intervention in St. Louis, and increased outreach to teens in foster care. The next governor will have the chance to decide whether to fund those or other programs.