The number of American women aged 15–44 who were covered by private insurance fell sharply between 2008 and 2009, as widespread job losses caused many Americans to lose employer-based insurance, according to a Guttmacher Institute analysis of new data released by the U.S. Census Bureau. The drop in the number of women of reproductive age who had private insurance was accompanied by significant increases in the number of women who were either uninsured or on Medicaid. The Census Bureau also reported a spike in the overall number of Americans living in poverty.

Guttmacher’s calculations show that the number of women aged 15–44 covered by private insurance fell by 2.3 million, from almost 39 million in 2008 to only 36.7 million in 2009. That translated into a decline of almost four percentage points in the share of women who had private insurance coverage (from 63.3% to 59.5%). Meanwhile, the number of women who were uninsured rose by more than 1.3 million, and the number of women on Medicaid increased by more than one million. In 2009, 22.3% of all women of reproductive age were uninsured and 14.8% were on Medicaid, compared with 20.1% and 13.2%, respectively, in 2008. Notably, the rate of reproductive age women who are uninsured rose faster—and was significantly higher—than for the U.S. population overall.

The bleak new data confirm previous Guttmacher research on the severe impact of the recession. In 2009, we documented that because of economic hardship, nearly half of low- and middle-income women wanted to delay pregnancy or limit the number of children they have, but that many had to skimp on their contraceptive use—or forgo it entirely—to save money. We also found that publicly funded family planning providers were struggling to meet a growing need for subsidized contraceptive care, even as they had to make do with fewer resources.

Taken together, the evidence paints a grim picture of fast-growing numbers of women struggling to afford contraceptives at a time when many say they can least afford to have a child (or an additional child). The findings underscore the critical importance of publicly funded family planning centers as safety-net providers for women who cannot otherwise afford the services and supplies they need to prevent an unintended pregnancy.

State-level data

For state-level data on the proportion of women who are uninsured, are on Medicaid or have private insurance coverage, please see the Guttmacher Data Center (Insurance Status, under Services and Financing)

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The recession’s impact on women

The recession’s impact on publicly funded family planning providers

Facts on publicly funded contraceptive services in the United States