Access to contraception is fundamental to reproductive autonomy and economic mobility for parents and their children. However, substantial upfront out-of-pocket costs for contraception severely limit access for those without health insurance. Though the Affordable Care Act (ACA) eliminated cost-sharing for contraception for those with health insurance, substantial cost-sharing remains for uninsured individuals who seek care through Title X: a national family planning program that offers subsidized, patient-centered reproductive health services for low-income individuals.

Bailey proposes two changes to Title X to make access to the contraception of choice more affordable:

  1. Make contraceptives free for low-income women through a change to the guidelines issued by the Department of Health and Human Services that defines the schedule of discounts; and,
  2. Increase congressional appropriations for the Title X program to fund this change in guidelines.

Similar to the ACA’s elimination of cost-sharing for contraception for Americans with health insurance, this proposal eliminates cost-sharing requirements for contraception for uninsured, low-income Americans through the Title X program.

This policy proposal is supported by direct evidence from a randomized control trial (RCT), described below. Eliminating cost-sharing for contraception through Title X would increase women’s ability to use their preferred contraceptive methods, reduce those pregnancies that they desire to delay or avoid, and generate substantial savings in government spending that could finance the program.

Read the full article about access to contraception by Martha Bailey at Brookings.