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Study: Contraceptive Use Dropped When Texas GOP Booted Planned Parenthood From Medicaid

Jessica Mason Pieklo

A report links an increase in Medicaid-paid births to diminished access to injectable contraception as a result of excluding Planned Parenthood affiliates from Texas' Medicaid program.

Excluding Planned Parenthood affiliates from Texas’ Medicaid program has resulted in widespread negative consequences for contraceptive users in the state, a study released Wednesday concluded.

For women using injectable contraceptives, those consequences included a nearly 30 percent increase in Medicaid-paid births.

The study, published February 3 in The New England Journal of Medicine, found that after Planned Parenthood affiliates were excluded from the Texas Medicaid program beginning in 2013, delivery of the most effective reversible methods of contraception, including IUDs, implants, and injectable contraception, decreased. Meanwhile, those patients using injectable contraception saw a 27 percent increase in Medicaid-paid births.

Claims for IUDs and implants declined 35 percent and claims for injectable contraceptives declined 31 percent.

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“Simply put, dedicated women’s health providers matter,” Dr. Joseph Potter, professor of sociology at the University of Texas at Austin, and study supervisor, said in a statement. “Providers who are mission-driven and have the requisite experience and knowledge appear to be critical for the delivery of the most effective methods of contraception—IUDs, implants, and injectables. From a demographic perspective, this is important because both national studies and local studies show that these methods dramatically decrease unintended pregnancy.”

Researchers drew their data from all Medicaid claims from 2011-2014, two years before and two years after the exclusion.

“This study isolates the effect of the exclusion not only on the delivery of services but also on subsequent deliveries paid by Medicaid,” Amanda Jean Stevenson, lead author and Ph.D. candidate in sociology at the University of Texas of Austin, said in a statement following the release of the study. “We examined differences between counties that had and did not have a Planned Parenthood affiliate, finding worse outcomes in places impacted by the exclusion; whereas places unaffected by the exclusion continued as they had before.”

Study co-author Pete Schenkkan, an Austin attorney who served pro bono as lead counsel for Texas Planned Parenthood affiliates in three court cases challenging attempts to cut the providers from public health programs, explained the implications of the study extends beyond Texas.

“The results of the study have implications for ongoing litigation regarding publicly funded women’s healthcare programs,” Schenkkan said in a statement following its release. “Initiatives to exclude medically qualified providers of family planning and other women’s health services if they are affiliated in any way with abortion providers have been adopted or proposed in 17 U.S. states and both houses of the U.S. Congress. Supporters of these proposals claim that other providers can meet the needs of women served by Planned Parenthood clinics.”

“Until now, this claim had not been empirically tested,” Schenkkan continued.

The study follows another published in the journal Contraception that found Planned Parenthood clients encountered barriers such as unnecessary exams, multiple visits, and additional costs as they tried to find a new provider once Planned Parenthood was excluded from the Medicaid program.

“The U.S. continues to have higher rates of unintended pregnancies than most rich nations, and we know that U.S. and Texas women face barriers as they try to access preventative services,” Stevenson said. “It’s a public health issue that Texas women struggle to achieve their reproductive goals.”

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