Research published in the New England Journal of Medicine examines the removal of Planned Parenthood affiliates from Texas’ fee-for-service family planning program. The study showed that excluding affiliates of abortion providers led to decreased provision of highly effective contraception and led to increased Medicaid-paid births. After the exclusion, provision of the most effective reversible methods of contraception decreased and Medicaid-paid births increased among injectable contraceptive users. Data was drawn from all Medicaid claims from 2011 through 2014, 2 years before and 2 years after the exclusion.

Claims for IUDs and implants declined 35 percent and claims for injectable contraceptives declined 31 percent. Among users of injectable contraception, Medicaid-paid deliveries increased by 27 percent.

 “Simply put, dedicated women’s health providers matter. Providers who are mission-driven and have the requisite experience and knowledge appear to be critical for the delivery of the most effective methods of contraception—IUDs, implants, and injectables. From a demographic perspective, this is important because both national studies and local studies show that these methods dramatically decrease unintended pregnancy. We also have accumulating evidence that there is unmet demand for these methods in Texas,” according to Dr. Joseph Potter, who supervised the study.

From Amanda Jean Stevenson, lead author and Professor of Sociology at University of Colorado Boulder: “This study isolates the effect of the exclusion not only on the delivery of services but also on subsequent deliveries paid by Medicaid. We examined differences between counties that had and did not have a Planned Parenthood affiliate, finding worse outcomes in places impacted by the exclusion; whereas places unaffected by the exclusion continued as they had before.”

“The U.S. continues to have higher rates of unintended pregnancies than most rich nations, and we know that U.S. and Texas women face barriers as they try to access preventative services,” Stevenson said. “It’s a public health issue that Texas women struggle to achieve their reproductive goals.”