The health policy nonprofit Kaiser Family Foundation has released the results of its most recent Women’s Health Survey and the data show a 4% decrease in the use of oral contraceptives, down from 33% in 2022 to 29% in 2024.
While some of the drop is due to a focused effort by conservative influencers to paint birth control as unsafe, this reduction is nothing compared to the decline to come. Cuts to Medicaid by conservatives in Congress, the withholding of federally funded Title X grants by the Trump administration and birth control restrictions at the state level are set to drastically reduce access to contraception across the country.
Nearly four out of 10 women of reproductive age have seen a post on social media about birth control within the past year. Half these were women ages 18 to 25 and 14% of them had considered making a change to their birth control method or made one because of something they saw or heard on social media.
An analysis by La Trobe University of the top five hashtags concerning contraception showed 53% of content creators rejected using hormonal birth control and 34% expressed distrust of medical professionals.
At least 30% of women report negative side effects from the pill, so some negative content from individuals sharing their personal experiences is to be expected. However, the posts driving the drop in oral contraception use are from right-wing influencers with anti-birth control agendas.
In 2023, the Heritage Foundation, the organization behind Project 2025, posted on X that there needed to be a “feminist movement against the pill.” MAGA mega-donors like the Koch Brothers and the Bradley Foundation finance Turning Point USA, which is aggressively pushing women to abandon hormonal birth control.
A place of privilege
While it’s concerning that women might stop taking the pill based solely on the advice of wellness influencers and conservative commentators, many of those weighing their options online are doing so from a place of privilege. They have access to health care providers and nonhormonal contraception alternatives that, while not as effective, are available. Those living in states where abortion is still legal also have that option. In short, these women can choose reproductive care consistent with their goals and values.
The same cannot be said for younger women, lower income women and women of color, who often find contraception care difficult to come by when compared to the access enjoyed by their older, wealthier, whiter sisters.
The cost of contraception is a barrier for many women. The KFF survey found 20% of women of reproductive age who lacked insurance were forced to forego using some form of birth control in the last year because of the price tag. Among women on Medicaid, 5% could not afford birth control, while 2% of women on private insurance found contraception unaffordable.
More than 75% of women receive reproductive health care at a doctor’s office, but 21% of low-income women and 28% of uninsured women access birth control at federally qualified health centers, Title X clinics, Indian Health Service clinics and rural health clinics, state and local health departments or Planned Parenthood clinics that comprise the country’s reproductive safety net.
Congress created a critical strand of that safety net in 1970 with the goal of improving health outcomes for mothers and infants. Title X of the Public Health Services Act guarantees free or low-cost reproductive health care, including contraception, for all who need it, especially patients who are not eligible for Medicaid and cannot afford such care otherwise. To disperse the funds annually approved by Congress, the federal government provides grants to a network of 4,000 community-based clinics, including state and local public health departments, tribal health clinics, hospitals and both public and private nonprofits. In 2023, the $286.5 million appropriated for Title X provided sexual and reproductive health care to 2.8 million people.
Attacking Title X
However, the Trump administration has been hard at work reducing the number of people benefitting from Title X services. Trump’s Department of Health and Human Services announced Title X health centers no longer may serve undocumented immigrants. This mandate is not legal under federal law, which requires clinics to serve all patients regardless of their immigration status. Fortunately, 21 states, along with the District of Columbia, secured a preliminary injunction blocking the administration’s attempt to deny contraception to this vulnerable community while the case makes its way through the courts.
“The Trump administration has been hard at work reducing the number of people benefitting from Title X services.”
On March 31, the Trump administration said it was “temporarily withholding” funding from 300 Title X grant recipients. Together these organizations serve 834,000 people, about 30% of all Title X patients. One of the groups affected was Bridgercare in Montana, which distributes money to 20 reproductive health clinics across the state. The letter Bridgercare received from the administration accused it of violating the Civil Rights Act and executive orders issued by President Trump.
Evidently a message on the group’s website welcoming “teens, LGBTQ individuals, and survivors of sexual assault” was deemed a DEI violation. Stephanie McDowell, executive director of Bridgercare, said, “We meet people where they are, and that oftentimes means letting people know that we’re a safe, welcoming space for them, regardless of their income, regardless of their identity.”
Members of the National Family Planning and Reproductive Health Association who had their Title X allocations withheld are currently suing the Trump administration. While some states have since received their allotted 2025 Title X grants, others have not.
In a budget plan authored by Office of Management and Budget Director Russ Vought — the mastermind behind Project 2025 — the administration plans to completely remove the $286 million for Title X from its 2026 budget along with the Teen Pregnancy Prevention Program. Without the grants, Title X care would be eliminated in California, Hawaii, Maine, Mississippi, Missouri, Montana and Utah and would be significantly scaled back in Alaska, Connecticut, Idaho, Indiana, Kentucky, Minnesota, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas and Virginia.
The projected $900 billion in Medicaid cuts included in the “Big Beautiful Bill” that passed Congress this summer also will challenge the ability of 13 million women of childbearing age to access contraception. Medicaid is one of the largest providers of sexual reproductive health care in America and covers 75% of all publicly funded family planning services, including birth control. Without reimbursement from Medicaid, many health clinics will be forced to close.
Indian Health Service clinics, where 40% of patients are on Medicaid, along with Rural Health Clinics in areas where one in four residents are enrolled in Medicaid, will be especially hard hit. The cumbersome work of reporting requirements mandated by the OBBA will cause millions of women to lose their health care and access to contraception.
Russell Vought (Photo By Tom Williams/CQ Roll Call via AP Images)
Compounding the Medicaid cuts is the end of the American Rescue Plan Act’s enhanced health insurance subsidies for the Affordable Care Act. Extended as part of the Inflation Reduction Act in 2022, these subsidies increased the amount of assistance available to those eligible for health insurance under the ACA and expanded eligibility to include middle-income families who previously could not afford coverage. Under the expansion, 8 million women of reproductive age qualified for health care. Without the enhanced tax credit, consumer premiums will increase an average of 75%, potentially leaving 5.7 million women of reproductive age without coverage.
The OBBA also included a provision that would strip Medicaid funding from Planned Parenthood for one year. Data from 2021 say 11% of people on Medicaid utilize a Planned Parenthood clinic for their family planning needs and 85% of those receive contraception. Although currently blocked by a federal court order, if this provision of the law is allowed to stand, it could shutter clinics in some communities, leaving them without a source of health care. This would impact even those who are not on Medicaid, as one third of all patients who obtain birth control from a public health clinic do so from Planned Parenthood clinics.
Even if the injunction against OBBA holds, a recent ruling by the U.S. Supreme Court in Medina v. Planned Parenthood South Atlantic allows states to block Medicaid recipients from seeking care at a Planned Parenthood clinic. This was a strategy proposed in Project 2025 and inspired by the work of states like Texas.
In 2013, when Texas excluded Planned Parenthood from its state-funded family planning program, fewer people received contraception and fewer were able to access hormonal birth control consistently enough for it to be effective.
Indiana has taken another route to limit contraception access. There officials have replaced IUDs and condoms previously offered by public health clinics with “fertility awareness-based methods” favored by social media influencers.
Thankfully, not all states are following suit. Gov. Gavin Newsom of California has just signed into law the Equity in Birth Control Act which will make it easier for residents of his state, including Medi-Cal enrollees, to access over-the-counter contraceptives with the help of a pharmacist.
Why this matters
Fighting to protect universal access to birth control — through Title X provisions, Medicaid funding, or other means — matters. Studies show when women have access to contraception, it increases their educational opportunities and their lifetime earnings. More importantly, effective contraception saves lives by decreasing maternal mortality and improving conditions for children.
It’s not too late for Congress to remove the barriers to birth control erected by the Trump administration. When party leaders return to the negotiating table to vote on the government funding bill, they can make the ACA subsidies permanent and ensure that women who buy private insurance through the ACA Marketplace retain access to birth control. They can restore Title X grants for clinics that provide contraception and care to low-income women and revise the burdensome Medicaid requirements that could force millions of women out of the program. You can help by contacting your congressional representative and your senators urging them to do so.
Contraceptives do much more than prevent unwanted pregnancies. They improve women’s health and their quality of life. Access should be a right for all, not a privilege for an affluent few.
Kristen Thomason is a freelance writer and journalist living outside Edinburgh in the United Kingdom. She has produced educational and promotional media for national and international religious organizations and public television. Kristen also worked with local churches in Metro D.C. and Toronto, Canada. With a master’s degree in communication and undergraduate degrees in media studies and classics, she is interested in the intersection of politics, religion, history and the arts.
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