Contraceptive access: What to expect from the new presidential administration

birth control pack and tampons in yellow clutch

As the new presidential administration takes office, broad changes are expected to policies affecting reproductive healthcare. Here, we outline anticipated impacts on access to contraceptive care.

Policies implemented in Trump’s first term as president, previous statements, and proposals from allied groups and policymakers indicate at least three ways that new actions could undercut people’s access to contraception, including in Wisconsin. The changes would be implemented primarily through funding streams and insurance coverage.

  1. The second Trump administration is expected to reinstate rules that limit Title X, a critical resource for family planning care.

The federal Title X program supports family planning and related services, including contraception, pregnancy testing and counseling, breast and cervical cancer screening, and sexually transmitted infection testing and treatment.

The previous Trump administration prohibited Title X funding to organizations that perform or refer for abortion services, or that even provide information about where a patient can obtain abortion services. During Trump’s first presidency, these rules devastated the Title X program’s reach to low-income patients nationally and in Wisconsin. CORE reviewed the resulting impact on providers and patients in a 2022 brief.

The impact: Additional restrictions to Title X are likely to reduce further the number of low-income Wisconsinites who can obtain essential family planning services including contraception. Such limits on access to reproductive healthcare will undermine Wisconsinites’ health and wellbeing in both the short term and long term.

  1. The new administration could again undermine the Affordable Care Act’s birth control benefit.

The Affordable Care Act guarantees coverage of contraceptive care at no cost in most health insurance plans. However, in the first Trump term, the administration permitted employers and educational institutions to refuse to cover birth control in their plans based on religious and moral exemptions. Such insurance exemptions increase out-of-pocket costs for individuals and families.

In addition, policy proposals for the new administration prepared by conservative think tanks urge eliminating emergency contraception from the Affordable Care Act’s contraceptive benefit by labeling it a “potential abortifacient.” (Emergency contraception does not end a pregnancy; it prevents pregnancy by preventing or delaying ovulation. This CORE brief explains.) While it’s unclear whether the administration will take up this mandate, in recent years, some policymakers and advocates have falsely portrayed contraceptives as causing abortion to limit contraceptive access. (Read an article by CORE researchers on this topic).

The impact: Cuts to insurance coverage of contraceptives would threaten people’s ability to pay for essential reproductive healthcare. Contraceptives are a critical part of the primary healthcare toolkit, offering a variety of health and social benefits for millions of people. Lack of contraceptive coverage will also increase the likelihood that people will experience undesired pregnancies.

  1. Public comments suggest that the administration may allow states to “defund” Planned Parenthood clinics by making the organization ineligible for reimbursement from state Medicaid.

The administration may also issue regulations that would make healthcare providers that offer abortion care, such as Planned Parenthood, ineligible for federal Medicaid funds for other care services. (Medicaid is co-funded by states and the federal government.) Existing federal law already prevents Medicaid from covering abortion care.

Tens of thousands of people each year receive essential reproductive healthcare services from Planned Parenthood of Wisconsin, including birth control, sexually transmitted infection tests, and cancer screenings. Cutting off Medicaid reimbursement would substantially reduce access to reproductive healthcare for these patients and would most harm people of color and people who are struggling financially. (See a 2021 CORE brief on this topic.)

The impact: Medicaid helps Wisconsinites who live on low incomes pay for essential reproductive healthcare services, from contraception to cancer screenings. Planned Parenthood of Wisconsin is a major provider of these services. If Planned Parenthood is made ineligible for reimbursement from Medicaid, thousands of people could lose access to reproductive healthcare. People of color and people struggling financially would be most impacted.