Texas excluded Planned Parenthood affiliates from the state-funded replacement for a Medicaid fee-for-service program, effective in 2013. This study assessed rates of contraceptive-method provision, method continuation through the program, and childbirth covered by Medicaid before and after the exclusion. Significantly, findings can be compared to the situation regarding HIV tests in the Houston area after Texas ended its 28 year HIV-prevention contract with Planned Parenthood Gulf Coast, leaving the Harris, Galveston, and Fort Bend County Health Departments to implement prevention interventions.
The study found that Planned Parenthood’s exclusion was associated with adverse changes in contraceptive provision, which mirrored a worrisome national trend of less funding and availability of specialized, skilled providers and more reliance on methods with lower rates of efficacy and continuation. In affected counties, researchers observed a substantial, unmet demand for the previously funded services offered by Texas Planned Parenthood affiliates. The most dramatic findings after the exclusion included a 35.5% reduction in claims for long-acting, reversible contraceptives; a 31.1% drop in those for injectable contraceptives; and a nearly 20% drop in women returning for continuing on-time contraceptive injections in counties with Planned Parenthood affiliates.