Publicly-funded clinics are crucial for providing contraceptive care to individuals facing healthcare access barriers, especially in rural areas of the US. Rural areas experience significant healthcare challenges, such as longer travel times, fewer provider options, and healthcare professional shortages. Current threats to federal funding, from the freezing of some Title X funds to the recent budget reconciliation bill that will likely reduce payments to many clinics providing high-quality contraceptive care, risk these clinics’ sustainability and patients’ contraceptive care accessibility.
The proposed study aims to understand how federal funding policy changes affect contraceptive access in rural areas between 2025 and 2027, focusing on seven states in Northern New England and Mountain West/Midwest. These states are among the most rural in the US and are likely to be significantly impacted by recent federal policy changes.
The research will employ a multi-pronged approach, using mystery caller techniques to assess service availability at all publicly-funded clinics that currently provide contraceptive care, analyzing electronic medical records, and examining birth certificate data. We will describe and compare trends in rural and metro contraceptive care utilization and health outcomes, and compare state-level policy responses to federal funding changes.
By collecting prospective data and assessing immediate impacts, the study will provide crucial insights for policymakers. The research aims to document how different state contexts interact with federal policy changes, offering a comprehensive understanding of potential consequences on access to contraceptive care in rural areas, particularly for those currently served by publicly-funded clinics.