Following the implementation of the Affordable Care Act (ACA), more family planning visits at a group of 32 safety-net centers supported by the Title X program are covered by insurance, according to a new Guttmacher analysis. The overall proportion of uninsured client visits at these centers decreased from 41% during the last three quarters of 2013 to 36% during that same period in 2014, driven by increases in visits paid for by both Medicaid and by private insurance.

Guttmacher is tracking the number of family planning visits and whether those visits were paid for with public, private or no insurance among 32 health centers that receive Title X funding. These centers include sites operated by health departments, Planned Parenthood affiliates and independent agencies in 20 states throughout the country, some of which have expanded Medicaid eligibility under the ACA and some of which have not.

"While not nationally representative, we believe these findings are a very good indicator that—as intended—the ACA is making health coverage more accessible and more usable to more people," says Kinsey Hasstedt, lead author of the new analysis. "Notably, two-thirds of the participating health centers saw a decrease in the proportion of uninsured family planning visits."

There was only a modest decrease in the overall number of family planning visits that took place at the 32 participating centers from 2013 to 2014, pointing to the enduring need for the network of publicly supported safety-net providers in the era of the ACA. The new analysis also shows that a considerable share of family planning client visits are still uninsured, emphasizing safety-net centers’ continuing need for funding support by programs like Title X.

"Our investigation once again confirms that Title X is a hugely important program, and that the nationwide network of safety-net family planning centers it supports is a vital source of care for millions," says Hasstedt. "This is true not only for the growing proportion of clients who have insurance coverage for their visits, but especially for the many clients who continue to lack coverage for the care they need."

The analysis concludes that policymakers, health plans and safety-net providers have much work to do so that clients can realize the full potential of family planning centers. This includes, first and foremost, the need to protect and expand funding for the embattled Title X program, and for states that have not yet expanded Medicaid under the ACA to do so. It also means ensuring that health plans include safety-net family planning centers in their provider networks, and that Title X providers become adept at working with health plans.

For detailed findings and charts of Guttmacher’s monitoring of 32 Title X family planning centers, please see the full article: "Still Needed: The Family Planning Safety Net Under Health Reform," by Kinsey Hasstedt, Yana Vierboom and Rachel Benson Gold.