In 2008, 17.4 million women were in need of publicly funded family planning services, an increase of 6%, or one million women, since 2000. In large part, this increase was due to a disproportionate rise in the number of poor women (those whose family income is below the federal poverty level) needing publicly funded contraceptive services and supplies. The increase coincides with a substantial increase during the same time period in the number of poor women in the overall population.
Publicly funded family planning centers have responded to this growing need, serving 7% more clients in 2008 than in 2001. According to “Contraceptive Needs and Services, National and State Data, 2008 Update,” these centers served more than seven million women in 2008, thereby helping to avert some 1.5 million unintended pregnancies that would have resulted in more than 650,000 unintended births and more than 600,000 abortions. Without these publicly funded family planning services, the overall U.S. unintended pregnancy rate would have been 47% higher and the abortion rate 50% higher.
At the same time, rising costs have made it even more difficult for publicly funded family planning centers to provide these much-needed services. In fact, the annual cost per contraceptive client increased by 27% between 2004 and 2008, likely reflecting factors such as sharp increases in the cost of contraceptive methods, use of more effective—but also more expensive—contraceptive methods and diagnostic testing, changes in clinical standards, and the challenge of addressing clients’ increasingly complex needs. These increasing client costs have resulted in a slight decline in the per-dollar cost savings from publicly funded family planning care. Still, by assisting women to avoid unintended pregnancies and plan when and how many children to have, publicly funded family planning clinics save taxpayers $3.74 for every $1 spent providing contraceptive care. Overall, the services provided in 2008 generated net public savings of at least $5.1 billion in Medicaid expenditures that would have otherwise been needed to provide medical care to women during pregnancy and delivery and to infants during their first year.
“As one might expect, poor women’s need for publicly funded contraception has increased because of worsening economic conditions,” says Sharon Camp, the Guttmacher Institute’s president and CEO. “The safety net of publicly funded family planning centers plays a critical role in helping women prevent unwanted pregnancies and plan the pregnancies they do want. But they are struggling to meet their clients’ needs as they confront growing case loads and increased costs, while public funding sources—such as the federal Title X program and state revenues—fail to keep pace with the need.”