The Reproductive Health Impact Study (RHIS) is a comprehensive research initiative that analyzed the effects of federal and state policy changes on publicly funded US family planning care from 2017 to 2024. The Guttmacher Institute worked with research and policy partners in four states—Arizona, Iowa, New Jersey and Wisconsin—to document the impact of these policies on family planning service delivery and the patients who rely on this care.

New Jersey was selected as an RHIS focus state in 2019 because of its long-established family planning network and policies that are generally supportive of sexual and reproductive health. This supportive environment was anticipated to provide a protective buffer against federal policy attacks, compared with the environments in states that are less supportive of sexual and reproductive health.

The information in this state profile reflects the landscape in New Jersey during the RHIS study period. For the most current information about the sexual and reproductive health research and policy landscape in New Jersey, visit our state information page.

Overall Findings

The RHIS findings demonstrate that restrictions on sexual and reproductive health and rights undermine people’s reproductive autonomy through negative outcomes at the patient, provider and system levels. Additional and unexpected disruptions to the landscape during the study period, such as the COVID-19 pandemic and the US Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade, exacerbated the harms of restrictive policies.

The main study findings include: 

• All types of sexual and reproductive health care are inextricably linked, and policy restrictions on sexual and reproductive health care have broader implications.
• Programs and policies that support person-centered care and focus on sexual and reproductive health equity are key to ensuring reproductive autonomy for all patients.
• Cost is a significant barrier to patients’ ability to access care and achieve reproductive autonomy.
• Person-centered contraceptive care is essential because contraceptive preferences vary.
• Publicly funded family planning programs, including Title X, are critical to making contraceptive services affordable.

New Jersey’s Sexual and Reproductive Health Landscape, 2017–2024

In 2020, New Jersey was home to 2 million women of reproductive age (15–49), 23% of whom had incomes below 200% of the federal poverty level.¹ In the same year, about 411,200 women in New Jersey were considered likely to have a need for publicly supported contraceptive care.² Additionally, 10.8% of women in New Jersey aged 15–49 were uninsured in 2019, compared with a national average of 12%.

Who Gets Publicly Funded Family Planning Services in New Jersey?

During the study period, the number of female contraceptive patients served at publicly funded clinics in New Jersey decreased. A publicly funded clinic is a site that offers contraceptive services to the general public and uses public funds (federal, state or local funding through programs such as Title X, Medicaid or the federally qualified health center program) to provide free or reduced-fee services to at least some clients.

In 2020, about 106,000 female contraceptive patients were served at publicly funded family planning clinics in New Jersey, a 4% decrease from 2015. Patients younger than 20 made up about 9,800 of this group, a 41% decrease from 2015.²

Only 26% of women in New Jersey considered likely to have a need for publicly supported contraceptive care were served by publicly funded clinics in 2020, about the same as in 2015 (25%).²

Where Do People Get Family Planning Services in New Jersey?

The total number of publicly funded family planning clinics in New Jersey decreased by 9% from 2015 to 2020, from 121 to 110. Of that total, the number of clinics receiving Title X funding decreased by 35%, from 49 in 2015 to 32 in 2020.²

In 2019–2020, women in New Jersey aged 18–44 most preferred to get contraceptives from a pharmacy (76%), via telehealth for pick-up or home delivery (68%), and in-person from a provider (63%). Across three states (Arizona, New Jersey and Wisconsin), 73% of women of reproductive age preferred more than one source for contraceptives. 

What Family Planning Policies Changed in New Jersey During the Study Period?

State and federal policy changes enacted during the RHIS study period affected the publicly supported reproductive health care system in New Jersey. Gov. Phil Murphy prioritized family planning and reproductive health care by restoring state family planning funding (eliminated under previous Gov. Chris Christie) in the first bill he signed when he came into office in 2018. Since 2018, New Jersey has expanded maternal care, including doula care, under Medicaid.

In 2019, the Trump-Pence administration implemented a series of changes to the Title X program’s administrative regulations that included a ban on abortion referrals, required physical and financial separation of Title X–funded activities from any related to abortion, and mandated coercive counseling standards for pregnant patients. As a result of this “domestic gag rule,” all Planned Parenthood affiliates left the Title X network later that year, including New Jersey’s two Planned Parenthood affiliates. Prior to this exit, nearly 70% of New Jersey patients served through Title X received care at a Planned Parenthood clinic. After leaving the network, these clinics continued to offer comprehensive family planning services using emergency funds. In March 2019, New Jersey joined 20 other states in filing a lawsuit opposing the gag rule. 

New Jersey responded to the consequences of the gag rule by providing robust state funding for reproductive and sexual health services. In December 2019, the state legislature approved an additional $9.5 million for entities that lost Title X funding. State funding also made it possible for all of New Jersey's family planning providers to continue offering comprehensive, unbiased family planning services, including nondirective counseling and referrals. 

In 2019, New Jersey launched Plan First, the state’s expanded Medicaid family planning benefit program, which provides coverage of family planning services to individuals who have incomes up to 205% of the federal poverty level. The program covers patients of all genders, all FDA-approved contraceptive methods and the human papillomavirus vaccine. 

New Jersey increased family planning funding to $10.4 million in fiscal year 2020 and $15.7 million in fiscal year 2021 to account for the rising need and cost of services. The state also expanded coverage of family planning services through a Medicaid state plan amendment. 

In 2021, the Biden-Harris administration’s Title X rule went into effect, revoking the 2019 rule and restoring the Title X national family planning program. That same year, Gov. Murphy won a close reelection for a second term and the state legislature remained in Democratic control, with a majority of legislators in support of reproductive rights and health. In 2022, the legislature passed a budget for FY2023 that committed $50 million for reproductive health care, including increased funds for family planning services. 

The New Jersey Family Planning League currently serves as the state’s grantee for Title X and the state-funded family planning services program and oversees both programs.

Patients’ Experiences of Reproductive Health Care in New Jersey

The restrictive state and federal policy changes enacted from 2017 to 2024 negatively impacted New Jersey residents’ ability to access reproductive health care. 

Barriers to Accessing Care

Restrictive state and federal policies undermine person-centered care, the patient-provider relationship and patient health outcomes. Person-centered care—health care responsive to an individual patient’s preferences and values—is a central tenet of reproductive autonomy. In 2019–2020, only about one-third (32%) of women aged 18–44 in New Jersey reported receiving “excellent” person-centered contraceptive care in the previous year.³

Although state-specific data are not available, national findings indicate that restrictive sexual and reproductive policies compound existing inequities. Therefore, harmful effects of the policies implemented during the RHIS study period are likely to have fallen particularly hard on marginalized groups in New Jersey, including communities of color, people with low incomes and immigrant communities.

Effects of COVID-19 and Dobbs on Care

Although state-specific data are not available, study data from other RHIS states indicate that the COVID-19 pandemic further exacerbated the harmful impact of restrictive sexual and reproductive health policies.

Abortion-related policy changes during the study period also impacted people’s ability to access contraceptive care, particularly in states that are not protective of abortion rights. In Arizona, Iowa and Wisconsin, there was a significant increase from 2021 to 2022–2023 in the share of reproductive-aged women who reported having trouble or delays in accessing their preferred contraception. In New Jersey, the most supportive RHIS state for abortion rights, there was no significant increase. However, all four states saw a significant decrease in the receipt of high-quality contraceptive care after the Dobbs decision.

Reproductive Health Care Providers’ Experiences in New Jersey

Restrictive state and federal policies disrupt providers’ ability to center and meet patients’ needs. They also increase existing inequities in sexual and reproductive health care, because these policies disproportionately impact marginalized groups.

Changes in Title X Funding

As a result of decreases or restrictions in funding, publicly funded family planning providers in all four RHIS study states—Arizona, Iowa, New Jersey and Wisconsin—had to rework payment options for patients. In some cases, providers helped patients who would not otherwise be able to afford care access other government, clinic or donor funding sources.

Between 2018 and 2021, the share of publicly funded clinics providing comprehensive contraceptive counseling decreased in all four RHIS states, including New Jersey. During this period, 75% of publicly funded clinics in New Jersey left the Title X family planning program, likely because of the gag rule. In New Jersey, state funding enabled many clinics to continue to provide comprehensive counseling without Title X funds.

COVID-19 and Reproductive Health Care Provision

The COVID-19 pandemic further complicated New Jersey providers’ ability to provide person-centered sexual and reproductive health care during the study period. Family planning providers adapted their operations—including by implementing additional safety protocols, shifting service delivery and staffing to meet patient needs, and expanding telehealth services—to continue providing care during the pandemic.

New Jersey’s Post-Roe Abortion Policy Landscape

Restrictive abortion laws can affect people’s ability to access contraceptive services and family planning providers’ capacity to provide contraceptive and other sexual and reproductive health care. Whether or not a reproductive health care provider offers abortion services, the ripple effects of abortion policies impact all types of care. 

Shortly before the Dobbs decision, in January 2022, New Jersey’s legislature enacted the Freedom of Reproductive Choice Act, which reinforces the state constitution’s protection of the right to abortion by explicitly ensuring the right to reproductive decision making, expanding insurance coverage for reproductive health care and preventing medically unnecessary restrictions on abortion care. 

Guttmacher considers New Jersey “very protective” of abortion rights. In New Jersey, abortion is not restricted based on gestational duration, and state Medicaid funds and private health insurance plans are required to cover abortion. Abortions can be provided by qualified health care professionals, not just physicians. New Jersey also has a shield law to protect abortion providers (and possibly patients and support organizations) from investigations by other states. 

The most current information about abortion-related policies in New Jersey is available on Guttmacher’s interactive map of US state abortion policies. 

State Partners

The Guttmacher Institute partnered with the New Jersey Family Planning League and other New Jersey-based research and policy partners for the RHIS. Additional information about reproductive health-related data and policies in New Jersey can be found in the following resources:

• New Jersey Department of Health: Reproductive Health Information Hub

• ACLU of New Jersey: Know Your Rights

   

NOTES 

1. Throughout this profile, we use the terms female and women to refer to individuals who may have the ability to become pregnant. However, not everyone who has the capacity to become pregnant identifies as female or as a woman. A limitation of the data sources used in our analyses is that they do not provide further detail on the sex or gender identity of respondents.