Data from the National Survey of Family Growth polls show an 8% decline in reproductive health services among young women from 2002 to 2008. Low-income women were shown to be the least likely to have obtained reproductive health services. Researchers identified several factors which may have contributed to this decrease. Among those factors identified were: “the decline in public sector clinics serving economically disadvantaged women; increasing unemployment and the corresponding lack of health insurance; updated gynecological health screening guidelines that require fewer Pap tests; and legislation that has increased mandatory parental participation in adolescent sexual and reproductive health care.”
The authors of the study postulated that their findings might reflect “‘changing social, economic, and political contexts in which reproductive services were needed…over the last decade’” but added that “new provisions for care under healthcare reform may bring some of those women back into care.” Shortly after healthcare reform was passed, the Guttmacher Institute released a news brief which summarizes some of expansions of reproductive healthcare services that healthcare reform will bring. It notes that “a provision expanding eligibility to all Americans with a family income below 133% of the federal poverty level will allow 16 million more Americans to join Medicaid by 2019 than would otherwise be the case.” The Medicaid expansion will allow more Americans access to the program’s guarantee of family planning services without cost sharing. Additionally, healthcare reform will allow those who are currently uninsured with incomes above 133% of the federal poverty line to purchase private insurance through the new health care exchanges, most of which will provide a similar package of reproductive healthcare to what Medicaid offers.
Given the risky behaviors among young people reported by the National Campaign to Prevent Teen and Unplanned Pregnancy, it is evident that supporting the implementation of healthcare reform as well as other efforts to make reproductive healthcare services more widely available is incredibly important. The Campaign’s data showed that among the young people polled, “nearly half of those who are in a sexual relationship either don’t use contraception at all or use it inconsistently, and almost 20% of all respondents predict that they’ll have unprotected sex within the next three months.” The result of this risky behavior is that “Seven in 10 pregnancies in the 18-to-29 age group are unintended, and men and women in their 20s have among the highest rates of sexually transmitted infections of any age group, including chlamydia, gonorrhea and syphilis.”
If you are interested in learning more about this issue, the National Survey of Family Growth study is available online, published by the American Journal of Public Health. 
To learn more about the Women’s Law Project’s work on women’s health, including on the implementation of Healthcare Reform and on reproductive health, visit our website, and stay tuned for our forthcoming publication, Through the Lens of Equality: Discrimination, Health, and a New Vision for Pennsylvania’s Women.

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