Protecting Reproductive healthcare Amidst Medicaid Changes
Recent federal legislation poses a meaningful threat to Medicaid coverage for millions of women of reproductive age, perhaps jeopardizing their access to vital healthcare and impacting their reproductive health, rights, and overall well-being. While the situation presents challenges, proactive steps at both the federal and state levels can mitigate these harmful effects and strengthen sexual and reproductive health (SRH) services nationwide.
Currently,a growing number of states are recognizing the importance of maintaining continuous Medicaid coverage,a move that prevents delays in care and automatically exempts individuals from burdensome work requirements. More than half the states have already adopted this approach, demonstrating a commitment to accessible healthcare.
However, maintaining access requires ongoing commitment, especially in the face of funding uncertainties. States must prioritize investments in sexual and reproductive healthcare, rather than reducing support. Cuts to these essential services would be counterproductive, negating the cost savings achieved through preventative care and ultimately leading to increased rates of unwanted pregnancies, sexually transmitted infections, and cervical cancer cases.
State policymakers have several avenues to bolster SRH services. Expanding Medicaid family planning programs, proven through numerous evaluations to generate net savings for Medicaid, is a crucial first step. Utilizing State Plan Amendments specifically designed for family planning can ensure continued access to critical services - including contraception, STI screening and treatment, and necessary lab tests – for individuals who may lose full Medicaid benefits.
Furthermore, states should explore increased funding for publicly supported clinics, enabling them to remain open and serve both current Medicaid enrollees and the growing number of uninsured individuals.Maximizing the versatility of telehealth services covered by Medicaid is another effective strategy to expand access to SRH care, ensuring a broad range of services are readily available.
This analysis estimates that approximately 6.7 million women aged 19-49 (roughly 40% of those enrolled in ACA Medicaid expansions) could be affected by potential coverage losses due to work requirements. This estimate is based on data from the US Census Bureau’s American Community Survey (ACS 2023) and projections from the Congressional Budget Office (CBO) and the Center on Budget and Policy Priorities. It underscores the scale of the potential impact and the urgency of proactive measures.
The federal budget reconciliation law presents a serious challenge,but it is not insurmountable. By acting decisively and strategically,federal and state policymakers can safeguard access to essential care and protect the sexual and reproductive health,rights,and autonomy of women across the United States.
Sources:
* https://www.guttmacher.org/report/publicly-supported-FP-services-US-2016
* https://www.guttmacher.org/sites/default/files/pdfs/pubs/Medicaid-Expansions.pdf
* https://www.cbo.gov/system/files/2025-08/61367-Uninsured-Data.xlsx
