The highly successful U.S. family planning effort helps almost nine million disadvantaged women each year to plan their families and protect their health, while also substantially reducing rates of unintended pregnancy and saving taxpayers more than $10 billion, according to a new Guttmacher report. The report, Moving Forward: Family Planning in the Era of Health Reform, synthesizes the most up-to-date data and analyses to illustrate the current and future importance of family planning programs and the safety-net providers at the heart of this effort.

"Our report is grounded in the fact that effective contraception is a critical part of basic health care for women," says Rachel Benson Gold, one of the report’s authors. "Publicly funded family planning services improve low-income and young women’s ability to use the method of contraception that is best for them, thereby yielding significant health, social and economic benefits for women, their families and society as a whole."

Government programs—notably, the Title X national family planning program and the joint federal-state Medicaid insurance program—have worked together for decades to improve access to contraceptives and related care. The report highlights these programs’ many vital contributions to women’s health, including:

• Nearly nine million women receive publicly funded family planning services each year. Three-quarters of these women (6.7 million) received this care from safety-net health centers and about 2.2 million from private physicians. Of these nine million women, 4.7 million obtained care from a health center that receives some funding through Title X.
• Publicly supported contraceptive care enables women to avoid 2.2 million unintended pregnancies each year; absent these services, U.S. rates of unintended pregnancy, unplanned birth and abortion would be two-thirds higher than they are.
• Underscoring the critical role these safety-net providers play in women’s lives, six in 10 women receiving contraceptive care at a health center consider that provider their usual source of care. For four in 10 women who visit a reproductive health–focused health center despite having other options, that provider is their only source of medical care throughout the year.
• Every public dollar invested in helping women avoid pregnancies they did not want to have saves $5.68 in Medicaid expenditures that otherwise would have gone to pregnancy-related care; in 2010, that amounted to a net government savings of $10.5 billion. Safety-net providers that receive some funding from Title X accounted for $5.3 billion of those net public savings.

However, because even this highly successful effort is only able to serve less than half of the 19.1 million women in need of publicly funded family planning services, the report also details steps to fully realize the Affordable Care Act’s (ACA) potential to bring insurance coverage and family planning services within reach for millions more. This forward-looking policy agenda aims to ensure that everyone in need of family planning services has affordable access to high-quality providers and comprehensive care, and that U.S. family planning programs and providers are secure for the women and couples who will continue to rely on them.

Specific recommendations include expanding Medicaid eligibility under the ACA (an option only half the states have utilized thus far); adopting targeted Medicaid family planning expansions, which are allowed under the ACA, to help ensure that women don’t fall through the cracks; bolstering Title X and other grant programs to support safety-net health centers; removing barriers to health insurance coverage, particularly for lawfully present immigrants; and ensuring that safety-net health centers are fully integrated into health plan networks.

"The recommendations discussed in our report should help publicly supported family planning providers to best serve their clients in today’s evolving health care system," says Gold. "But despite the many positive changes under the ACA, these providers still face many challenges such as tightening government budgets and political attacks on funding sources and providers themselves."