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For more than 50 years, a network of public programs and providers have assisted millions of reproductive age (18 to 49) women with low incomes in the U.S. to obtain sexual and reproductive health services. Over the past decade, the landscape of reproductive health care has changed dramatically as a result of shifts in federal and state policy as well as legal challenges and court rulings that have reshaped the state and federal laws that govern these programs. Recently, the 2025 Budget Reconciliation Law prohibits federal Medicaid payments for one year to some family planning providers that also offer abortion services, and the President’s most recent budget request proposes to eliminate funding for the federal Title X family planning program. This brief explains the major sources of public financing for family planning care, related policies, and their role financing services for low-income women.
Family planning encompasses a wide range of counseling, prevention, and treatment services that nearly all women use during their lifetimes. Contraceptives are the primary service, which most women use over the course of their lifetimes. Many options are available from clinicians including permanent methods, long-acting methods such as IUDs and Implants, as well as pills, injectables, patches, and rings. Over–the-counter methods include condoms and emergency contraception pills and more recently, Opill, a daily oral contraceptive pill. In addition to contraceptives, family planning includes sexual health services such as STI testing and treatment, gynecologic exams, and pregnancy testing (Figure 1).
Financing reproductive health care for people with low incomes comes primarily from a variety of public programs, including Medicaid, the federal Title X Family Planning Program, Section 330 of the Public Health Service Act (PHSA), and the Indian Health Service. Clinics and other providers may receive funds from a combination of these programs, which are described below.
Medicaid is a health coverage program for individuals with low incomes that covers more than 15 million reproductive age women nationally. Like private insurance, Medicaid pays clinicians and clinics for health services they provide to their patients. Jointly operated and funded by the federal and state governments, Medicaid provides health coverage to one in five women of reproductive age and more than four in ten (44%) who have low-incomes (Figure 2). The share of low-income reproductive-age women enrolled in Medicaid varies considerably by state, ranging from a high of 34% in Louisiana to a low of 10% in Utah. These differences are the result of a variety of factors, including demographic differences between states such as the share of women with low incomes, availability of employer-sponsored insurance, state choices about Medicaid eligibility, particularly whether the state has expanded Medicaid to all adults up to 138% FPL as permitted by the Affordable Care Act (ACA) and state-established income eligibility thresholds for parents in the non-expansion states. For these women, Medicaid provides comprehensive affordable coverage to help meet the full range of their health care needs, including family planning services.
Because it covers so many people, Medicaid is the largest source of public funds for family planning services. Federal law stipulates that family planning is a “mandatory” benefit that states must cover under Medicaid, but states have considerable discretion in specifying the services and supplies that are included in the program. Additionally, the ACA requires most private insurance plans and Medicaid expansion programs to cover the full cost of prescribed contraceptive methods for women. Most state Medicaid programs cover the full range of FDA approved contraceptives available to women, counseling and treatment for STIs and HIV, and screening for cervical cancer. Medicaid reimburses clinicians for delivering family planning care, just as it pays for other medical services.
Abortion services are not considered to be family planning, and the Hyde Amendment prohibits any federal dollars, including Medicaid reimbursements, from being used to pay for abortion care except in cases of rape, incest or life endangerment of the woman. Other federal requirements that shape family planning policy under Medicaid include:
Free Choice of Provider and Medicaid
Historically, the federal Medicaid statute has required states to allow all willing and qualified providers to participate in their Medicaid programs. States were not permitted to exclude or disqualify providers just because they offer abortion services in addition to preventive family planning services. However, a Supreme Court ruling and a new federal law in 2025 have upended this requirement.
The Title X National Family Planning Program, a federal block grant administered by the HHS Office of Population Affairs (OPA), is the only federal program specifically dedicated to supporting the delivery of family planning care. The program funds organizations in each state to distribute federal dollars to safety-net clinics to provide family planning services to low-income, uninsured, and underserved people. In 2023, approximately 4,000 clinics nationwide received Title X funding, including specialized family planning clinics such as Planned Parenthood centers, primary care providers such as federally qualified health centers (FQHCs), and health departments, school-based, faith-based, and other private nonprofits. In 2023, 60% of clients seen at Title X clinics had family incomes at or below the poverty level, almost half (46%) were covered by Medicaid or another public program, and more than a quarter (27%) were uninsured (Figure 4).
Signed into law by President Nixon in 1970, the Title X program’s funding has remained flat at $286.5 million for the past ten years. In addition to providing clinics with funds to cover the direct costs of family planning services and supplies such as contraceptives, Title X funds enable clinics to pay for patient and community education services about family planning and sexual health issues, as well as infrastructure expenses such as rent, utilities, information technology, and staff salaries. Clinics that receive Title X funds are also eligible to obtain discounted prescription contraceptives and devices through the federal 340B program. No other federal program makes funds available to support clinic infrastructure needs specifically for family planning. Clinics that receive Title X funds also receive Medicaid and private insurance reimbursements for specific clinical services they provide to enrollees with coverage. Title X grantees cannot charge patients with low incomes out of pocket for services they receive, and for people with annual family income above 250% FPL, charges should be on a sliding fee schedule based on ability to pay.
Title X regulations have historically stipulated that participating clinics must provide clients with a broad range of contraceptive methods as recommended by the national Quality Family Planning Guidelines (QFP), and ensure that the services are voluntary and confidential. This has been interpreted to mean that minors do not require parental involvement to obtain family planning services as a Title X funded site. The current QFP guidelines serve as standards for delivery of clinical sexual and reproductive health services and address a range of issues, including STIs, fertility, and gender-affirming care. Federal rules also require that participating clinics offer their patients non-directive pregnancy options counseling that includes abortion, adoption, and prenatal referral for those who seek those services. These requirements, however have changed with different presidential administrations shaping who can participate and what services can be offered.
Most reproductive age women obtain reproductive care from a private doctors’ office; however many women with lower incomes get family planning services through the publicly funded health care safety-net, which is comprised of a variety of providers such as federally qualified health centers (FQHCs) and look-alike clinics, state and local health departments, the Indian Health Service, and specialized family planning clinics. Nationally, more than four in ten (43%) reproductive age women with Medicaid coverage had their last contraceptive visit at a safety-net clinic. This varies widely though, and in some states safety-net clinics play a larger role (Figure 5).
Under Section 330 of the PHSA, the Health Resources and Services Administration (HRSA) administers federal grants to Federally Qualified Health Centers (FQHCs) whose main focus is providing primary and preventive care to populations that are underserved and predominantly low-income. FQHCs are required to provide “voluntary family planning” services along with a wide range of health care services, but they do not necessarily specialize in providing sexual and reproductive health care. Although it is not specifically defined in FQHC guidelines, voluntary family planning services can include contraceptives, screening and treatment of STIs, pre-pregnancy care and fertility counseling but the range of services that health centers offer can vary. FQHCs must have a sliding fee scale for patients with incomes below 200% FPL and offer services to all patients regardless of their ability to pay.
Specialized clinics such as Planned Parenthood centers focus on family planning and reproductive health care, typically offering the full range of contraceptives and other sexual and reproductive health services such as STI testing and treatment, cervical cancer screenings, and pregnancy testing. These clinics also employ clinicians and staff with expertise in family planning care. Planned Parenthood clinics comprise a relatively small portion of clinics that receive public financing for family planning services but have historically served a disproportionate share of safety-net patients (Figure 6).
State and local health departments offer public health services such as vaccines and chronic disease screenings to people who are low-income or uninsured. In many communities, they also offer family planning services, such as HPV vaccines and a limited range of contraceptive services. State and local health agencies may incorporate family planning counseling and services as part of other core public health functions, particularly maternal and child health programs.
The Indian Health Service (IHS), an agency under the Department of Health and Human Services, provides a wide range of health services to approximately 2.8 million American Indian and Alaska Native (AIAN) individuals via a network of hospitals, clinics and health stations. Federal regulations require IHS to cover health promotion and disease prevention services, which include family planning services and STI services. However, the availability of contraceptive methods varies by clinic. Services at IHS and tribal clinics are provided with no cost-sharing and are generally only available to members or descendants of federally recognized Tribes who live on or near federal reservations.
Over the next few years, a confluence of policy changes at the federal level will challenge the network of publicly supported programs and clinics that provide access to free and low cost family planning services. The 2025 Budget Reconciliation law blocks Planned Parenthood clinics from receiving federal Medicaid payments for one year, cutting off a primary source of revenue from a major provider of sexual and reproductive health care for people with low incomes. Additionally, the President and other Republican leaders have proposed eliminating funding for the Title X program. Yet, the Congressional Budget Office estimates an increase of 10 million uninsured individuals over the next decade from the Budget Reconciliation law and the sunsetting of supplemental ACA premium tax credits at the end of 2025 could raise this number even further. With a steep rise in the number of uninsured people, clinics will likely face higher demand in the aftermath of sharp decreases in financing, greatly challenging an already fragile reproductive health safety net.
The 2025 budget reconciliation legislation requires states to condition Medicaid eligibility for adults in the ACA Medicaid expansion group on meeting work requirements starting January 1, 2027, but states have the option to implement requirements sooner using an 1115 waiver.
Prior to the passage of the federal reconciliation legislation and since the start of the second Trump administration, some states have shown renewed interest in pursuing work requirement policies through 1115 waivers. Some states may no longer be moving forward with proposed 1115 waivers due to the passage of federal work requirements; Montana is the only state that has submitted a waiver since the passage of the 2025 budget reconciliation legislation. While states are required to fully align with federal work requirements starting January 1, 2027, it is not clear how CMS will treat pending 1115 waivers that seek to implement early and deviate from federal requirements (specified in the law) prior to this deadline.
The first Trump administration encouraged and approved 1115 demonstration waivers that conditioned Medicaid coverage on meeting work requirements which were subsequently rescinded by the Biden administration or withdrawn by states. Currently, Georgia is the only state with a Medicaid work requirement waiver in place following litigation over the Biden administration’s attempt to stop it. CMS recently approved a temporary extension for Georgia’s waiver that added new exemptions from work requirements (see the table below for more details). Georgia’s waiver is now set to expire December 31, 2026, and the state will be required to come fully into compliance with new federal requirements starting January 1, 2027.
The map below identifies approved (Georgia) and pending work requirement waivers (submitted to CMS since the start of the second Trump administration). The table below the map provides more detailed state waiver information.
For more information on Section 1115 Waivers visit our Medicaid Waiver Tracker.
Media reports indicate that the Trump administration’s Department of State issued new guidance that directs visa officers to consider a wide range of health conditions when reviewing visa applications to enter the U.S. under the premise that these conditions could lead to people becoming a “public charge,” or reliant on the U.S. government for subsistence. KFF’s news operation, KFF Health News, examined the guidance and reported that “foreigners seeking visas to live in the U.S. might be rejected if they have certain medical conditions, including diabetes or obesity, under a Thursday directive from the Trump administration.” Further, President Trump has indicated that this policy will ban entry for “those whose poor health will overburden our health care system.”
Visa applicants already undergo medical exams and screenings, but the guidance expands the list of health conditions for visa officers to consider and provides significant discretion to officers to predict the potential long-term health and financial implications of common chronic conditions. The guidance applies to people seeking entry for permanent residence in the U.S. for work or to be with family as well as to those applying for temporary visas. The guidance extends President Trump’s broad efforts to restrict immigration into the U.S. and will likely increase barriers to family reunification and reduce the pool of available workers in the U.S., including H-1B workers, who come to the U.S. to work temporarily in specialty occupations like engineering, technology, and medicine.
Soon after this guidance was issued, the Department of Homeland Security also proposed new regulations that would rescind a 2022 Biden-era rule related to public charge determinations that apply to people seeking adjustment to lawful permanent resident (LPR or green card) status within the U.S. The guidance and proposed rule would significantly increase discretion provided to immigration officers in making public charge decisions and could allow them to consider factors that had been excluded under the 2022 rule, including use of health, nutrition, and housing programs such as Medicaid, the Children’s Health Insurance Program (CHIP), and the Supplemental Nutrition Assistance Program.
This analysis examines the share of noncitizen and citizen adults currently living in the U.S. who have one of the health conditions identified in the visa guidance. It is based on KFF analysis of the 2024 National Health Interview Survey (NHIS) sample adult file (see Methods for more details). While the analysis focuses on individuals already residing in the U.S., it provides insight into the scope of people who might be affected while seeking entry to the U.S.
The analysis shows that almost half of noncitizen immigrant adults in the U.S. have one of the health conditions listed in the guidance, dropping to about four in ten who arrived in the U.S. recently, but they are less likely to have these conditions than their citizen counterparts. Nearly half of noncitizen adults (47%) have one of the health conditions identified in the guidance compared to two in three (66%) citizen adults. Among noncitizen adults who have been residing in the U.S. for less than five years, about four in ten (39%) report having at least one of these conditions.
Under longstanding law, federal officials can deny entry to the U.S. or adjustment to lawful permanent resident (LPR) status (i.e., a “green card”) to someone they determine to be a public charge. The law specifies that officials must consider certain minimum factors when making public charge determinations, including age; health; family status; assets, resources, and financial status; and education and skills.
While immigrants seeking entry to the U.S. have long been required to undergo a health assessment as part of the visa application process, according to news reports, the U.S. Department of State recently issued a directive to embassies and consular offices instructing visa officers to consider a broader range of health conditions when reviewing visa applications, citing these health conditions as potentially draining U.S. resources. Under longstanding policy, immigrants seeking entry to the U.S. have been required to undergo health assessments as part of the visa application process. However, the health assessment generally only considered whether an applicant had a specified communicable disease, such as tuberculosis; a serious physical or mental health condition; and proof of certain vaccinations. The new guidance directs visa officers to consider a broader set of chronic health conditions in making visa determinations, “including, but not limited to, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions.” It encourages officers to consider other conditions, like obesity, which it notes can cause asthma, sleep apnea, and high blood pressure. The guidance also directs visa officers to consider the health of family members, including children or older parents.
The guidance indicates that officers should consider these health conditions to assess whether an immigrant could become a public charge and denied entry into the U.S. If an individual seeking a visa to reside in the U.S. has one of the identified chronic conditions, the guidance directs officers to consider whether the applicant has adequate financial resources to cover the costs of medical care over “his entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense.” As such, it relies on significant discretion of visa officers to make long term predictions about the health and financial implications of health conditions even though they are not trained medical professionals.
Data show that almost half of noncitizen immigrant adults in the U.S. have one of the health conditions listed in the guidance, dropping to about four in ten who arrived in the U.S. recently, but they are less likely to have these conditions than their citizen counterparts. As of 2024, nearly half (47%) of noncitizen immigrant adults in the U.S. report ever having at least one health condition that could be considered when applying for a U.S. visa under the guidance. About three in ten (29%) report being obese, 10% report ever having diabetes, 8% report ever having depression, 7% report ever having an anxiety disorder, 6% report ever having asthma, with smaller shares reporting ever having cancer, coronary heart disease, myocardial infarction (heart attack), stroke, angina, or dementia (Figure 1). Significantly higher shares of U.S. citizen adults report having these health conditions, with two in three (66%) reporting having at least one. Immigrants who have arrived in the U.S. more recently are even less likely to report one of these health conditions, with about four in ten (39%) of noncitizen immigrant adults who have been in the U.S. for less than five years reporting ever having at least one. These lower rates likely reflect them being younger and healthier than their U.S. citizen and longer-residing immigrant counterparts.
The new Trump administration visa guidance will further restrict immigration into the U.S., creating barriers to family reunification and limiting the pool of available workers, including H-1B workers, who come to the U.S. to work temporarily in specialty occupations like engineering, technology, and medicine. Immigrants, including noncitizen immigrants, play a significant role in the U.S. workforce in occupations such as health care, STEM, agriculture, and construction. Further, research suggests that immigrants tend to have lower health care expenditures than U.S.-born citizens and may help to subsidize the health care costs incurred by their U.S.-born counterparts. Moreover, the guidance, along with the proposed rule to remove 2022 public charge regulations, will likely make immigrant families more reluctant to access health care and health coverage due to confusion and fear about public charge rules. KFF/New York Times 2025 Survey of Immigrants data show there already has been an increase in the share of immigrant adults reporting avoiding health care and/or assistance programs for themselves or their families due to President Trump’s immigration policies.
Methods
Data source: These findings are based on KFF analysis of the 2024 National Health Interview Survey (NHIS) sample adult file. NHIS is a continuous national survey of the U.S. civilian non-institutionalized population conducted by the Centers for Disease Control and Prevention. The 2024 sample adult file contains 32,629 observations of individuals 18 years and older.
Identifying noncitizen immigrants: Noncitizen immigrants are identified as those whose citizenship status is reported as “No, not a citizen of the United States” (n=2,089) whereas U.S. citizens are identified as those whose citizenship status is reported as “Yes, a citizen of the United States” (n=29,279). Individuals who are identified as noncitizen immigrants are further broken out into those who report being in the U.S. for less than five years and those who report being in the U.S. for five or more years.
Identifying health conditions included in new visa guidance: Based on details listed in news reports, the following health conditions from NHIS were included in this analysis: ever having angina; ever having anxiety disorder; ever having asthma; ever having any cancer; ever having coronary heart disease; ever having dementia; ever having depression; ever having diabetes; ever having a heart attack (myocardial infarction); ever having a stroke; or having a body mass index of 30 or higher.
Note: Relative standard errors for shares of recent noncitizens reporting having cancer, coronary heart disease, heart attack, stroke, angina, or dementia are larger than 30% which may impact the reliability of these estimates.
In this JAMA Viewpoints column, KFF’s Drew Altman, Ashley Kirzinger and Mollyann Brodie explore the power of health care affordability as an economic issue, how it has played out in recent election cycles, and the implications for the 2026 midterm elections. The column notes how health care increasingly has become a dimension of voters’ economic worries rather than a stand-alone issue, which explains why the debate about whether to extend the Affordable Care Act’s expiring enhanced tax credits has so much salience now that could continue into the midterms if Congress does not strike a deal to address rising costs for consumers. It also explains why Medicaid cuts will have power as an issue even though the cuts will be phased in over time.
Note: This interactive includes data from before January 2025, and therefore does not reflect the potential impact of changes implemented by the Trump administration since then. For more information, see KFF’s Overview of President Trump’s Executive Actions on Global Health and The Trump Administration’s Foreign Aid Review: Status of the President’s Malaria Initiative (PMI).
This dashboard monitors the status of the U.S. President’s Malaria Initiative’s (PMI) partner countries’ progress toward global malaria targets. It includes data for 30 countries, including 27 focus countries in Africa (including the three PMI partner countries – Burundi, Gambia, and Togo – that were added in 2023) and three countries in the Greater Mekong Subregion in South-East Asia.* Together, these 30 countries represent almost 90% of the global malaria burden. Data are from the WHO’s World Malaria Report 2024. The data powering this dashboard are available for download here. KFF will continue to track PMI country progress on these indicators and update the dashboard as new data become available.
*PMI countries include the following: Angola, Benin, Burkina Faso, Burma, Burundi, Cambodia, Cameroon, Côte d’lvoire, D.R. Congo, Ethiopia, Gambia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Tanzania, Thailand, Togo, Uganda, Zambia, and Zimbabwe. U.S. President’s Malaria Initiative (PMI), Where We Work, accessed: https:/www.pmi.gov/what-we-do/. PMI, Press release: U.S. President’s Malaria Initiative Announces Plans to Expand to New Partner Countries, accessed: https://www.pmi.gov/u-s-presidents-malaria-initiative-announces-plans-to-expand-to-new-partner-countries/.
Note: This interactive includes data from before January 2025, and therefore does not reflect the potential impact of changes implemented by the Trump administration since then. For more information, see KFF’s Overview of President Trump’s Executive Actions on Global Health and The Trump Administration’s Foreign Aid Review: Status of U.S. Global Tuberculosis Efforts.
This dashboard monitors the status of USAID’s tuberculosis (TB) priority countries’ progress toward global TB targets. It includes data for 24 countries* in which USAID’s bilateral TB program carries out TB efforts. Data are from the World Health Organization’s (WHO) Global Tuberculosis Report 2025. The data powering this dashboard are available for download here. KFF will continue to track country progress on these indicators and update the dashboard as new data become available.
* USAID TB priority countries include the following: Afghanistan, Bangladesh, Burma, Cambodia, Democratic Republic of Congo, Ethiopia, India, Indonesia, Kenya, Kyrgyz Republic, Malawi, Mozambique, Nigeria, Pakistan, Philippines, South Africa, Tajikistan, Tanzania, Uganda, Ukraine, Uzbekistan, Vietnam, Zambia, and Zimbabwe. USAID, Global Tuberculosis Countries webpage, accessed: https://www.usaid.gov/global-health/health-areas/tuberculosis/countries.
Note: This interactive includes data from before January 2025, and therefore does not reflect the potential impact of changes implemented by the Trump administration since then. For more information, see KFF’s Overview of President Trump’s Executive Actions on Global Health and The Trump Administration’s Foreign Aid Review: Status of PEPFAR.
This dashboard monitors the status of PEPFAR countries’ progress toward global HIV targets from 2019-2024. It includes data for 54 countries required to develop a PEPFAR Country or Regional Operational Plan (COP/ROP) in FY 2024. To use the dashboard, click on any indicator and select a year to see country-level data for that year. Click on Trends Over Time to see the progress countries have made in recent years. Data are from UNAIDS AIDSinfo database and were last updated in July 2025. Data for the latest available year are for 2024. The data powering this dashboard are available for download here. KFF will continue to track PEPFAR country progress on these indicators and update the dashboard as new data become available.
On June 24, 2022, the Supreme Court overturned Roe v. Wade, eliminating the federal constitutional standard that had protected the right to abortion. Without any federal standard regarding abortion access, states will set their own policies to ban or protect abortion. The Abortion in the United States Dashboard is an ongoing research project tracking state abortion policies and litigation following the overturning of Roe v. Wade. Click on the buttons or scroll down to see all the content. It will be updated as new information is available.
This policy watch explains how abortion coverage works in ACA Marketplace plans, state actions to include or exclude abortion coverage in these plans, and the potential impact if Congress bans abortion coverage in all Marketplace plans.
This brief reviews current state and federal policies, ongoing litigation, and potential federal actions that may impact access to telehealth for medication abortion.
This policy watch provides an update on the status of abortion restrictions in states that passed a constitutional amendment protecting abortion, or where a state court previously interpreted the state constitution as protecting abortion access.
This policy watch outlines SCOTUS’ June 27, 2024, decision dismissing the case, Moyle v. United States, where the Court had been asked to determine if a federal law called the Emergency Medical Treatment and Labor Act preempted Idaho’s abortion ban. The decision returns the case to the lower courts and reinstates a court order blocking enforcement of the Idaho ban where it prohibits abortion care for pregnant people having medical emergencies.
The Supreme Court will be hearing oral arguments for the case FDA v. Alliance for Hippocratic Medicine. This brief explains the issues at stake before the court and their implications for the drug regulatory process and medication abortion access throughout the country.
This brief provides background on the Comstock Act, reviews how it has been interpreted by the Biden Administration’s DOJ, and considers how it could be enforced by an administration that is hostile toward abortion to severely restrict the distribution of drugs and supplies used for abortion, with implications for abortion access in all states across the country.
While all eyes were on Texas and the recent case of Kate Cox, a woman seeking a court order allowing her abortion under an exception to the Texas abortion ban, the conflict could have played out in many states. The risk to doctors is so high that many doctors are hesitant to provide life-saving abortion care unless the threat to life is imminent.
This brief explains why individuals may seek abortions later in pregnancy, how often these procedures occur, and the various laws which regulate access to abortions later in pregnancy across the country.
Ten of the 21 states with abortion bans or gestational limits do not have an exception for pregnancies resulting from sexual assault. In the 11 states with rape and incest exceptions, the details and fine print make can make access to abortion care unattainable for pregnant survivors of sexual assault. Law enforcement reporting requirements, early pregnancy gestational limits, and the lack of provider availability present major barriers to abortion access, even when the state has an exception.
This State and Federal Reproductive Rights Litigation tracker aggregates information about ongoing litigation regarding abortion bans and restrictions, FDA approval of Mifepristone (an abortion pill) and other federal regulations.
This brief examines the legal considerations for physicians providing abortion care, including criminal and professional penalties, as well as the potential for medical malpractice lawsuits for delayed care to patients due to bans and prosecution for violation of abortion bans across state lines.
This brief examines what the November election and prior efforts to enshrine abortion rights at the ballot box mean for those states and what’s next, including the future of abortion restrictions in states where voters enshrined abortion rights where abortion was banned or restricted, as well as those that do not have abortion bans.
Presidential candidate Trump claims credit for SCOTUS’ Dobbs decision and says that as a result, the “states are voting.” States are making decisions on abortion policy, but it’s mostly been state legislatures, not voters. Few states with abortion bans have a process for citizen-initiated constitutional amendments. In those states, lawmakers and anti-abortion activists have attempted to block abortion measures from qualifying for the ballot or put roadblocks in their place.
Over four in ten (45%) abortions occur by six weeks of gestation, 36% are between seven and nine weeks, and 13% at 10-13 weeks. Just 7% of abortions occur after the first trimester.
This brief reviews the different sources of abortion data in the United States, the factors that have affected abortion rates across the U.S, before and after Roe v. Wade, and what we may see as the Trump administration, Republican majorities in the House and Senate, and a conservative federal judiciary shape policy in the coming years.
This factsheet provides an overview of medication abortion, with a focus on federal and state regulations pertaining to its provision and coverage, and the role of the drug in self-managed abortions.
This brief reviews current state and federal policies, ongoing litigation, and potential federal actions that may impact access to telehealth for medication abortion.
Several states have enacted private plan restrictions and have also banned abortion coverage from ACA Marketplace plans. Currently, there are 10 states that restrict abortion coverage in private plans and 25 that ban coverage in any Marketplace plans.
This Policy Watch takes a look at employers ability to access abortion information when their health plan covers abortion services. With some states criminalizing entities who assist in abortions, employers and providers face legal jeopardy and existing privacy laws such as HIPAA (the Health Insurance Portability and Accountability Act) may be limited in their privacy protections.
This brief looks at Medicaid reimbursement rates for abortion services across states, including D&C and D&E procedures, and medication abortion. There is tremendous variability in how much states reimburse for abortion services.
This brief details the federal programs that are affected by the Hyde Amendment and laws and regulations that have a similar goal, provides estimates on the share of women insured by Medicaid affected by the law, reviews the impact of the law on their access to abortion services, and discusses the potential effect if the law were to be repealed.
This data note documents the costs associated with abortion care in private plans. Also, KFF analyzes how out of pocket spending has been affected by state laws that require full coverage of abortion services.
This Policy Watch gives an overview of employers offering to cover travel expenses for workers who need to go out of state for an abortion in the context of increasing restrictions on abortion around the country. We discuss who is offering these benefits, the implications for workers, and some of the legal and political concerns for employers.
This brief presents findings from the 2023 KFF Employer Health Benefits Survey on coverage of abortion services in large employer-sponsored health plans, changes employers made to abortion coverage since the 2022 Supreme Court ruling, and employers’ provision of financial assistance for travel out of state to obtain an abortion.
This brief examines pregnancy loss management in the Dobbs era and explores how limiting or banning abortion may have negative consequences on people experiencing miscarriage or stillbirth.
This report, based on a nationally representative survey of office-based OBGYNs practicing in the United States, examines the provision of sexual and reproductive health care provided by OBGYNs before and after the Dobbs decision, comparing the experiences of OBGYNs practicing in states where abortion is fully banned, states with gestational restrictions, and states where abortion remains available under most circumstances.
Native Hawaiian or Pacific Islander, American Indian or Alaskan Native and Black people are more likely to die while pregnant or within a year of the end of pregnancy compared to White people
Six in ten of Black (60%) and AIAN (59%) women ages 18-49 live in states with abortion bans or restrictions. Just over half (53%) of White women ages 18-49 live in states with bans or restrictions, while less than half of Hispanic (45%) and about three in ten Asian (28%) and NHPI (29%) women ages 18-49 live in these states
This poll finds 1 in 8 voters say abortion is the most important issue to their vote. They are younger, lean Democratic, and generally want abortion to be legal in all or most cases. The poll also gauges the public’s views on abortion-related policies, including a national 16-week abortion ban and allowing abortion for pregnancy-related emergencies.
Our latest poll finds one in five women of reproductive age in states with abortion bans say either they or someone they personally know has had difficulty obtaining an abortion. Majorities of women across states—including in those with abortion bans—think abortion should be legal in all or most cases and support a range of policies that protect abortion access.
This brief provides new information from the 2024 KFF Women’s Health Survey about women’s experiences with abortion, the fallout of overturning Roe v. Wade, women’s knowledge about abortion laws in their states including medication abortion, as well as their opinions on the legality of abortion.
This brief provides information about abortion experiences, awareness, and attitudes of Florida women ages 18 to 49, based on findings from the 2024 KFF Women’s Health Survey, a nationally representative survey on health care issues.
This brief provides information about abortion experiences, awareness, and attitudes of Arizona women ages 18 to 49, based on findings from the 2024 KFF Women’s Health Survey, a nationally representative survey on health care issues.
Share of abortions by age, gestational age and method type.
