By Melinda Young
People with private health insurance typically obtain their contraceptive methods from private doctors’ offices, in-store clinics, or pharmacies, while just about everyone else relies on publicly funded health centers and family practice clinics for contraceptive care, a new study says.1
The study uses data from a 2022 Behavioral Risk Factor Surveillance System of female contraceptive users in 26 states.1 “The study’s results aligned with our previous research, showing publicly insured and uninsured users are more likely to rely on public clinics for contraceptive care than are privately insured users,” says Hannah Olson, PhD, MSPH, a senior research scientist at the Guttmacher Institute in New York, NY. People who obtained insurance through the Affordable Care Act’s marketplace were included in the self-pay, private category, Olson adds.
The study’s findings highlight the importance of federally qualified health centers (FQHCs) and other federally funded health centers, such as family planning clinics. These entities are under threat of being defunded by the current administration.
Within the first month of the new administration, some community health centers closed or cut back on staff because of blocked access to federal funding. Even after a court issued an injunction against the spending freeze, some grant programs — including Title X — reported financial shortfalls, according to news reports in February 2025.2,3
For example, the chief executive officer of Tri-Area Community Health, which has nine clinics in Virginia, said their federal grant portal payment was delayed by eight days, causing financial havoc.3 These types of disruptions and the threat of future funding cuts to health clinics that rely on federal funding could crush contraception access to the most vulnerable women.
“What if state and federal contraceptive services are cut back? We are very attuned and keeping our finger on that pulse,” Olson says. “This paper does not speak to that directly, other than emphasizing how important these publicly supported providers are and understanding that in their absence, there would be folks that forego care.”
While most Americans access healthcare through private providers, private insurance is inaccessible to people with limited resources, she notes. “Public resources are important,” Olson says. “Providing care through these safety net clinics is crucially important for folks with limited resources, particularly those who are uninsured.”
Other factors that may affect contraception access include Medicaid expansion, which has been implemented in all but 10 states that are located primarily in the Southeast, but also include Wisconsin, Kansas, Texas, and Wyoming.4 Medicaid expansion Title X funding for family planning clinics is important for improving contraception access, Olson notes.
“Clinics that receive Title X support provide a broader range of contraceptive methods and more specialized family planning care,” she explains. “We want to highlight how important it is that they provide services regardless of income or insurance.” Title X programs also tend to provide more person-centered care than clinics that do not specialize in family planning, she adds.
The study’s takeaway message emphasizes the importance of community health centers and family planning clinics in providing contraceptive care, especially for those who have limited resources and are uninsured or publicly insured.1
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1. Olson H, Kavanaugh ML. Where do female contraceptive users get their methods, and does this differ by insurance coverage? A state-level examination. Contraception. 2025; Jan 30:110834. [Online ahead of print].
2. Hellmann J, Raman S. Community health centers caught up in funding freeze. Rollcall.com. Feb. 6, 2025. https://rollcall.com/2025/02/06/community-health-centers-caught-up-in-funding-freeze/
3. Schabacker E. Health clinics left reeling after federal grant freeze. Cardinal News. Feb. 10, 2025. https://cardinalnews.org/2025/02/10/health-clinics-left-reeling-after-federal-grant-freeze/
4. Status of State Medicaid Expansion Decisions. KFF. Feb. 12, 2025. https://www.kff.org/status-of-state-medicaid-expansion-decisions/
People with private health insurance typically obtain their contraceptive methods from private doctors’ offices, in-store clinics, or pharmacies, while just about everyone else relies on publicly funded health centers and family practice clinics for contraceptive care, a new study says.
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