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The Population Institute Releases its 2014 Report Card on Reproductive Health and Rights

January 08, 2015

The Population Institute today released its third annual report card on reproductive health and rights in the U.S., and the results were mixed. Fifteen states receive a failing grade, and the U.S. as a whole received a “C,” slightly better than last year’s “C-.” In releasing the report card, Robert Walker, the organization’s President, said, “Nationally, the status of reproductive health and rights improved over the past year. The reported teenage birth rate, while still high, continued to fall, and as a result of the Affordable Care Act more women are able to access affordable reproductive health care. Those advances are largely responsible for the slight improvement that we see in the national grade. At the state level, however, there were several setbacks for reproductive health and rights. Next year, if Congress and the states cut funding for family planning and impose arbitrary restrictions on abortion services, or if Congress repeals or limits contraceptive coverage under the Affordable Care Act, the U.S. grade could slip back in 2015. ”

Walker warned that, “The results of the 2014 election could have a major impact on women’s reproductive health and rights. In the last couple of years Congress has rejected efforts by social conservatives in the House to de-fund family planning programs, but the results of the 2014 elections and the change in control of the Senate could result in renewed attempts to slash family planning funds. At the state level several states are drastically reducing their funding for family planning and restricting funding to Planned Parenthood and other providers of contraceptive services and following the election look for that trend to continue.”

Report Card Map

Using nine criteria, the Institute’s report card ranked each of the 50 states and the District of Columbia:

  • Thirty percent of the grade is based on measures of effectiveness. This includes the latest available data on the teenage pregnancy rate (15%) and the rate of unintended pregnancies (15%).
  • Twenty percent of the grade is based upon prevention. This includes mandated comprehensive sex education in the schools (15%) and access to emergency contraception (5%).
  • Thirty percent of the grade is based upon affordability. This includes if states are expanding Medicaid under the Affordable Care Act (10%), Medicaid eligibility rules for family planning (10%), and funding for family planning clinics serving low-income families (10%).
  • The final twenty percent of the grade is based upon clinic access. This includes abortion restrictions (10%) and percent of women living in a county without an abortion provider (10%).

Based upon their scores, each state received a “core” grade (A, B, C, D or F), but some states received an additional “plus” or a “minus“ for factors not reflected in the core grade, such as pending changes or legislation.  

Only seventeen states received a B- or higher. Just four states (California, New Mexico, Oregon and Washington) received an “A”. Fifteen states received a failing grade (“F”). States receiving a failing grade included Alabama, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Virginia, and Wyoming.

Walker said, “This year should have been a great victory for women’s reproductive health with tumbling teen pregnancy rates and increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 23 states have refused to expand their Medicaid coverage leaving millions without increased access to services and states continued their attacks on reproductive rights.”

The teen pregnancy rate has continued its incredible drop to historic lows, a 51% decline since its 1990 peak and a 15% drop between 2008 and 2010. That said, it is clear that more needs to be done America’s teenage pregnancy rate is still higher than any other industrialized nation and nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that all women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education.

Walker stressed that this report should be a call to action: “Women’s access to reproductive health care should not depend on where she lives, but increasingly, it does. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states.”

For a copy of the report, including a state-by-state breakdown, visit the Population Institute’s website ( 

A special thanks to the Guttmacher Institute whose research made this report card possible.

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