New Research Shows State Restrictions Reduce Contraception Use

After Iowa stopped sending federal and state money to abortion clinics for free contraceptives five years ago, the share of their patients who postponed reproductive health care nearly doubled and the share who stopped using any form of birth control spiked by two-thirds, according to new research by the Guttmacher Institute, which supports abortion rights.

Iowa still bars abortion clinics from receiving public contraception funds. At least 16 other states have similar restrictions, including Arizona, Arkansas, Colorado, Indiana, Michigan, Mississippi, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas and Wisconsin, according to the institute.

“Everyone should be able to choose and use the contraceptive method that works for them, free from cost-related barriers,” said lead author Megan Kavanaugh, principal research scientist at Guttmacher.

“Given the increased restrictive climate around abortion in our country, we are anticipating amped-up attacks on contraceptive access, as both of these are efforts that target people’s reproductive autonomy and freedom,” she added.

Guttmacher’s research describes the change in contraceptive use that occurred after Iowa opted out of a Medicaid family planning program in 2017 and set up its own state-funded contraception program, which excluded clinics that provided abortion along with other health services.

The study found that the share of patients at publicly funded family planning centers in Iowa who had not recently received contraceptives increased from 32% to 62% over two years. The share of patients not using any contraceptive method increased from 9% to 15%.

Roughly 50 million, or 65% of women of reproductive age, 15-49, used some form of contraception from 2015 to 2017, the federal Centers for Disease Control and Prevention says.

According to the Kaiser Family Foundation, 1 in 3 low-income people who use contraception rely on Planned Parenthood or other publicly funded clinics to pay for the often-costly pills or devices. Medicaid, which covers about 70 million individuals, is the largest funding source for free contraception.

Another federal program, Title X, provides additional funds to roughly 4,000 clinics across the country to support access to contraception. During the Trump administration, those funds were withheld from Planned Parenthood and other clinics that provide abortion.

In July, the U.S. Department of Health and Human Services issued a reminder to insurance companies that birth control, along with other preventive care, must be covered under the Affordable Care Act at no cost.  The agency said the action was part of a Biden administration effort to protect women’s access to contraception in the wake of the U.S. Supreme Court decision that eliminated the longstanding federal right to abortion.

“Under the ACA, you have the right to free birth control — no matter what state you live in,” HHS Secretary Xavier Becerra said in a statement. “With abortion care under attack, it is critical that we ensure birth control is accessible nationwide, and that employers and insurers follow the law and provide coverage for it with no additional cost.”