On Wednesday September 24, a coalition of 22 attorneys general and the state of Pennsylvania filed a motion for a preliminary injunction against the Trump administration to block the “defunding” of Planned Parenthood. That policy, which was part of the budget reconciliation bill passed in July, excludes certain health centers, including all those affiliated with Planned Parenthood, from reimbursement through the federal Medicaid program. In support of the coalition’s complaint, Guttmacher Institute Principal Research Scientist Megan L. Kavanaugh, DrPH, submitted a legal declaration, drawing on her expertise regarding contraceptive care and publicly supported family planning services in the United States.
Dr. Kavanaugh’s declaration lays out the comprehensive body of research demonstrating the importance of publicly supported sexual and reproductive health (SRH) care in addressing health inequities and the critical role that Planned Parenthood plays in delivering that care.
“The research is clear: Planned Parenthood is a vital component of the publicly supported family planning system and defunding these clinics is about politics, not health care,” says Dr. Kavanaugh. “Excluding Planned Parenthood health centers from Medicaid reimbursement will not only disrupt the larger health care system but will severely impact the individuals who rely on this care to live full and healthy lives. As this case makes clear, a person’s right to bodily autonomy should never be dependent on their economic or insurance status.”
The declaration makes several key points:
Medicaid plays a critical role in making contraceptive care affordable
Research shows that cost is a major barrier to SRH care and that people often cease using contraceptives due to an inability to pay. Accordingly, publicly funded clinics are a critical source of SRH care for people who rely on Medicaid and other forms of public insurance. Guttmacher research shows that:
- In 2023, 21.4% of women aged 15–49 were enrolled in Medicaid, and that proportion went up to 52.8% for women aged 15–49 with incomes below the poverty line.
- As of 2019, 39% of US women aged 15–44 relied on Medicaid and other public insurance to cover their contraceptive care, and 33% of those obtaining care at publicly supported health care sites used their Medicaid and other public insurance to cover such care.
- Women with Medicaid coverage or those who were uninsured were more likely than privately insured women (71% and 70% vs. 53%) to report a publicly funded clinic as their usual source of care.
Planned Parenthood is a key provider of publicly supported SRH care
While Planned Parenthood clinics comprise a relatively small proportion of the publicly supported SRH care system overall, they serve an outsized number of patients who receive care from this system. Guttmacher research shows that:
In 2021, one in 10 Medicaid enrollees received their SRH care at a Planned Parenthood clinic.
In 2020, 9,388 publicly supported clinics provided subsidized family planning services nationally and only 6% were Planned Parenthood sites. However, Planned Parenthoods served 33% of the 4.7 million women who obtained contraceptive care from publicly supported clinics that year.
53% of Planned Parenthood patients relied on Medicaid and other government-funded programs to pay for their care.
Defunding Planned Parenthood will cause significant harm
Using service data from Planned Parenthood's most recent annual report, Guttmacher quantifies the preventive services offered at Planned Parenthood clinics across the country that are at risk of no longer being provided because of the “defund” provision. According to Guttmacher, these services each year avert:
- 82,000 chlamydia infections
- 9,500 cases of pelvic inflammatory disease (PID)
- 820 ectopic pregnancies
- 1600 cases of infertility
- 130 HIV infections
- 200 cervical cancer cases
For decades, Guttmacher has tracked the publicly funded family planning landscape, compiling estimates of the number of women who need SRH care, characteristics of these patients, and details on where this care is obtained. The latest data show:
- In 2020, there were likely 19 million women with a need for publicly supported contraceptive care, yet it is estimated that only 7.2 million received this support.
- If Planned Parenthood is unable to serve patients who rely on public insurance, it is unrealistic for other types of facilities in the public health care system to absorb the millions of clients Planned Parenthood serves. To do so, these other facilities would have to increase their contraception caseloads by the following percentages:
- Federally qualified health center (FQHC) sites by 56%, or an additional one million contraceptive clients per year.
- Health department sites by 28%, or an additional 168,000 contraceptive clients per year.
- Hospitals by 53%, or an additional 344,000 contraceptive clients per year.
- Other sites, such as those operated by independent agencies, by 55%, or an additional 189,000 contraceptive clients per year.