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Reproductive Health and Rights in U.S. Under Assault

January 07, 2016

The Population Institute today released its fourth annual report card on reproductive health and rights in the U.S., and the results were alarming. This year nineteen states received a failing grade and the U.S. grade fell from a “C” to a “D+.” In releasing the report card, Robert Walker, the organization’s President, said, “Inflamed by heavily edited videos attacking Planned Parenthood, the hostility to reproductive health and rights has reached a fever pitch in the past year. There has been an avalanche of legislation—both proposed and enacted—to restrict clinic access and reduce funding for Planned Parenthood and other family planning providers.”

In 2015 the U.S. House of Representatives voted seven times to defund Planned Parenthood, an action that would deny millions of women access to a trusted health care provider. The U.S. House Appropriations Committee voted again in 2015 to eliminate all funding for Title X, an action that would deny millions of women access to contraception and other vital health care services, including cancer screenings. Abortion restrictions in Texas and in other states have forced the closures of dozens of family planning clinics.  Worse still, the physical assaults on clinics—ranging from vandalism and arson to the devastating shooting that occurred at the Planned Parenthood clinic in Colorado Springs—are creating a climate of fear.

Walker warned that, “The attacks on Planned Parenthood are potentially devastating. Planned Parenthood health centers make up only 10 percent of publicly funded safety-net providers, but they serve 36 percent of the clients seeking contraceptive services. In 103 counties with a Planned Parenthood health center, the Planned Parenthood facility serves all the women who are using safety-net clinics to access contraceptive services. The restricted access to reproductive health care would be particularly devastating for poor women and women living in remote areas.”

Walker expressed concern about efforts in Congress to eliminate funding for comprehensive sex education programs in the schools. “Political attacks on teen pregnancy prevention programs have received very little attention, but they endanger the progress we have been making in reducing teen pregnancy rates.”

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%).

·         Twenty-five percent of the grade is based upon affordability. This includes if states are expanding Medicaid under the Affordable Care Act (15%) and Medicaid eligibility rules for family planning (10%).

·         The final twenty-five percent of the grade is based upon clinic access. This includes abortion restrictions (10%), TRAP Laws (5%), 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 Jersey, Oregon and Washington) received an “A”. Nineteen states received a failing grade (“F”). States receiving a failing grade included Alabama, Arkansas, Florida, Georgia, Idaho, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, Virginia, and Wyoming.

“At the state level the trend is particularly worrisome,” said Walker. “Increasingly, the reproductive health of a woman depends on the state or community where she lives. That’s wrong as a matter of both rights and health.” Walker noted that 21 states have refused to expand Medicaid under the Affordable Care Act. Walker also noted that 288 new abortion restrictions have been approved since January 2011, and that several states have cut funding for family planning services.

Sex education in the schools also varies widely.  Some states require no sex education, while others fail to require any instruction about use of condoms, birth control or the prevention of HIV/AIDS.  As a result, the quality of sex education can—and does—vary widely from one school district to the next.  And, unfortunately, efforts to defund or restrict comprehensive sex education are gaining momentum at both the federal and state levels.

Walker said, “This report card should be a wake-up call for all those worried about the status of reproductive health and rights in their state.”

For a copy of the report, including a state-by-state breakdown, visit the Population Institute’s website (  For questions about the report, call Jennie Wetter, Director of Public Policy, at (202) 544-3300, ext. 108.

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

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