Contraception is a critical component of health and well-being, allowing people to prevent pregnancy, space and plan their pregnancies, manage and treat medical conditions, and prevent sexually transmitted infections. However, many people in the United States face steep barriers to accessing contraceptive services, which may be unaffordable for them or unavailable where they live. For over half a century, the publicly funded contraceptive care network has helped people surmount those barriers, providing funds for free or reduced-cost contraception through programs such as the Title X Family Planning Program and insurance coverage through Medicaid.

Unfortunately, this network is unable to fully meet people’s need for contraceptive care. New research from Guttmacher and Power to Decide provides a comprehensive picture of where gaps exist between the potential need for publicly funded contraception services and access to that care. This fact sheet draws on that research to explore a scenario in which Planned Parenthood health centers were removed from the publicly funded contraceptive care network. While this network includes a range of provider types— including public health departments and federally qualified health centers (FQHCs)— Planned Parenthood clinics play a pivotal role in this system, serving many patients who cannot otherwise afford or access contraceptive care. Nationwide, Planned Parenthood health centers served 1.6 million (33%) of the 4.7 million contraceptive clients who accessed publicly funded family planning centers in 2020. 

For decades, however, lawmakers and activists opposed to abortion rights have been lobbying to “defund Planned Parenthood” and trying to force the closure of Planned Parenthood health centers around the country. Amid sustained campaigns of mis- and disinformation, states have passed laws restricting Planned Parenthood’s ability to care for patients and the first and second Trump Administrations have compromised Title X’s reproductive health funding to clinics. In July 2025, anti-abortion forces came closer than ever to achieving these goals when the Republican majority in Congress passed HR 1, legislation that included an effective federal ban on Medicaid reimbursements to Planned Parenthood clinics for one year. After the law passed, nearly 30 Planned Parenthood clinics closed before the provision expired in July 2026.

Given these relentless attacks, it is important to understand the potential impact across the country if Planned Parenthood health centers were removed from the publicly funded contraceptive care network. The new research on access to contraception reveals that—of the estimated 21.5 million women^* who likely need public support for contraceptive care in the United States—very few live in a county with adequate contraceptive access. Currently, Planned Parenthood plays a key role in the fractured US health care system, ensuring that people in these underserved counties have access to at least some of the contraceptive care they need. Research has shown that without Planned Parenthood, other types of health centers could not accommodate those patients without dramatically increasing their capacity.

This fact sheet and accompanying map depict a scenario in which Planned Parenthood health centers could no longer access federal funding for contraceptive care. It highlights the estimated percentage change in access to publicly funded contraceptive care if Planned Parenthood health centers were no longer eligible to receive federal funding through Title X and Medicaid, and explores this potential impact at the county-level regionally and nationally.

Key Findings

Number of women impacted

• If Planned Parenthood health centers were removed from the publicly funded contraceptive care system, 12.4 million women in need of publicly funded contraceptive care would be affected, representing 58% of the total number of US women likely to need this care. (Affected women are those living in a county that would experience any level of reduced access.)

Planned Parenthood is the only publicly funded contraceptive provider in 29 US counties, most of which are located in the Northeast and Midwest regions. The 240,860 women in need of publicly funded contraceptive care who live in those counties would lose their only source of affordable contraceptive care if the Planned Parenthood health centers in these counties were unable to provide these free or reduced-cost services. This loss of access would increase by 24% the number of women with no access to contraceptive care, which stands at over one million even with Planned Parenthoods in the system.

• The largest absolute numbers of women who would be affected by Planned Parenthood’s removal from the publicly funded system are concentrated in the West and South. The West, the hardest-hit region by total women affected, has 4.1 million women across 94 counties who would face reductions in contraceptive access, driven largely by California’s 2.3 million women—more than 1 in 10 of all women in need nationally. The South adds another 3.7 million women across 68 counties, with Texas accounting for 1.3 million of those women. The Northeast adds another 2.3 million women across 84 counties, with nearly 963,000 women in need of publicly funded contraceptive care living in the 59 counties that would face reductions in access exceeding 50%.

County-level reductions in contraceptive access

• Planned Parenthood affiliates operate in 316 counties, which constitute 10% of all counties in the United States. If all Planned Parenthood clinics were removed from the publicly funded system, 213 counties would experience at least a 50% reduction in contraceptive access from existing levels. These severe reductions in access would impact 6.7 million women (31% of all women in need of publicly funded contraceptive care). 
• In 122 of the 316 counties (39%) where Planned Parenthoods are located, the local publicly funded clinic network is able to serve at least a quarter of women in need of affordable contraceptive care. Without Planned Parenthood health centers providing this care, only 21 (7%) of those counties could meet that threshold of need, which would represent a steep decline in contraceptive access across more than 100 counties. 
  
• Planned Parenthood health centers provide the majority of publicly funded contraceptive care across parts of the West and Midwest. In many of these counties, women in need of publicly funded care would face a near-total loss of access if Planned Parenthood health centers were removed from the network. Such women in Washington and Oregon would see a median reduction in contraceptive access exceeding 77%. Women living in Wisconsin's 12 affected counties would face a median access reduction of 96%, and women across 20 affected counties in Ohio and Michigan would face median reductions of 68% and 79% respectively. 

Why the Potential Loss of Planned Parenthood’s Affordable Contraceptive Care Matters

Planned Parenthood health centers provide an essential resource for patients who face financial and geographic barriers to accessing contraceptive care. Planned Parenthood’s absence from the publicly funded contraception network would have a devastating impact on patients across the country, with many regions experiencing an acute loss of affordable care. These cascading harms would be even more severe if the ongoing federal “defunding” efforts end up forcing more Planned Parenthood clinics to close, as they did in 2025 and 2026, with patients losing access to reproductive health and cancer screenings, gender-affirming care, abortion care and sex education.

Furthermore, attacks on Planned Parenthood are not happening in a vacuum. They are accompanied by Trump administration efforts to reshape the Title X network into a program that places more emphasis on pronatalism than reproductive autonomy and which would push people toward fertility awareness-based methods over other contraceptive methods, regardless of their preference. These efforts would erode high-quality, evidence-based standards of care and accountability and profoundly aggravate health inequities. HR 1 will also impose significant changes on Medicaid starting in 2027, including work requirements that threaten to eliminate Medicaid coverage for 2.1 million women aged 19‒49 (an age bracket in which women are most in need of reproductive health care).

In a health policy landscape shaped by ideological demands and punitive reductions in coverage, cuts to Planned Parenthood’s contraceptive service provision are most likely to impact those already struggling to access care. It is critical that policymakers and advocates stand up to the attacks on Planned Parenthood and other reproductive health providers who offer abortion care and advance policies that fully support all providers within the publicly funded contraceptive care network. That includes fully funding and strengthening Title X and ensuring that all Medicaid enrollees can use their coverage at the provider of their choice. For state lawmakers, it means they must do all they can to support access to reproductive health and to mitigate restrictive federal policies—as 15 states did when they committed emergency funding to help fill the gap in response to the one-year Medicaid defunding provision in HR 1. Without such funding and protections, millions of people could lose access to the contraceptive care that is essential to their health and well-being.

Methodology

This analysis draws on two key variables, each from distinct sources:  

(1) County-level contraceptive access. This variable represents county-level estimates of alignment between availability of publicly funded health centers providing contraception and women’s need for this care. Data on county-level contraceptive access come from The Contraceptive Access Maps, a collaborative effort between Power to Decide and the Guttmacher Institute.^† 

(2) County-level need for contraceptive services. This variable represents county-level numbers of women with a self-defined need for contraceptive care and who likely need public funding for this care—calculated as the sum of women under age 20 and women ages 20‒49 under 250% of the federal poverty level who indicate a self-defined need for contraceptive services in the county. Data on county-level need for contraceptive services come from New Measure of Self-Defined Need for Contraceptive Services in the United States, 2023, a recently published report from the Guttmacher Institute. 

Estimates of baseline county-level contraceptive access are drawn from The Contraceptive Access Maps and reflect access based on the provider landscape during 2020‒2023, which includes the nearly 30 Planned Parenthood sites that subsequently closed between July 2025 and June 2026 following the loss of federal Medicaid funding. We narrowed the baseline data to focus only on counties where Planned Parenthood affiliates operate within the broader publicly funded contraceptive care health system. Among this narrowed sample of counties, we recalculated estimates of county-level contraceptive access without Planned Parenthood affiliates, following the approach adopted for The Contraceptive Access Maps. Briefly, estimates of county-level contraceptive access were calculated by dividing the estimated number of patients served by the publicly funded network present in the county by the estimated number of women in the county under age 20 and under 250% of the federal poverty level with a self-defined need for contraceptive services. These preliminary estimates were capped at 1.0, and a distance penalty was applied. For this analysis, we removed county-level Planned Parenthood clinic numbers and patient caseloads and reran the original calculations.

The percentage change in county-level contraceptive access was then calculated for each of the 316 counties where Planned Parenthood affiliates operated, as the difference between the baseline estimates (including Planned Parenthoods) and the narrowed estimates (excluding Planned Parenthoods) expressed as a proportion of the baseline estimates. We examined the county-level impact of removing Planned Parenthoods from the overall landscape of publicly funded contraceptive care both in terms of percentage change in access (as described) and in absolute number of women affected, drawing on county-level need for contraceptive services. We looked at national-level impact as well as state and regional impact based on the four US Census regions. This analysis does not account for whether states would or would not use state funds to support individuals’ contraceptive care as a remedy in the absence of federal Medicaid dollars.