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Reproductive Health and Rights in Free Fall

January 12, 2017

Population Institute’s Report Card Lowers U.S. Grade to a “D”; 20 States Fail.

Continued Attacks on Planned Parenthood and Closure of Clinics Cited

 WASHINGTON, D.C. – The Population Institute today released its fifth annual report card on reproductive health and rights in the U.S., and the results were alarming. This year 20 states received a failing grade and the U.S. grade fell from a “D+” to a “D.” In releasing the report card, President Robert Walker said “We saw continued slippage of reproductive health access at the state level, where political attacks on family planning and Planned Parenthood have forced several dozen clinics to close. The worst, though, may be yet to come.”

Only twenty-one states received a B- or higher. Twenty states received a failing grade (“F”), including Alabama, Arkansas, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, and Wisconsin. Just five states (California, New Jersey, New Mexico, Oregon and Washington) received an “A”.

This year’s report card also highlights a growing national divide on reproductive health and rights. Walker warned that “A woman’s reproductive health should not depend on where she lives, but increasingly it does. Women in many states are experiencing reduced access to reproductive health care services, including abortion.” Walker noted that 19 states have refused to expand Medicaid under the Affordable Care Act, leaving tens of millions of women without improved access to contraception and other health care services.

At the federal level, Congressional opponents of family planning and abortion rights were largely unsuccessful in 2016.  Emergency funding for the Zika crisis, however, was held up for months, when the House Appropriations Committee attempted, unsuccessfully, to prevent Planned Parenthood from getting any of the funding.  House appropriators also tried again—and failed—to slash funding for both comprehensive sex education and Title X, which provides financial support to family planning clinics serving low-income women.

Walker warned that, “The attacks on Planned Parenthood and family planning are taking a toll. For the past five years reproductive health access has been on a slippery slope, and it’s about to go into a free fall. In 27 states today more than 50 percent of women live in a county without an abortion provider, and because family planning clinics in many states are being forced to close, an increasing number of women face barriers in accessing family planning services.” 

Using eleven 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-five percent of the grade is based upon prevention. This includes mandated comprehensive sex education in the schools (15%), access to emergency contraception (5%), and minors access to contraceptive services (5%).

·         Twenty-five percent of the grade is based upon affordability. This includes if states are expanding Medicaid under the Affordable Care Act (15%), Medicaid eligibility rules for family planning (5%), and restrictions of insurance coverage of abortion (5%).

·         The final 20 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 (5%).

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.  

Federal support for reproductive health and rights could suffer a major reversal in 2017.  Congress and the new Administration are expected to curtail access to contraceptive services by blocking all funding for Planned Parenthood and Title X, a program that has been providing support for family planning clinics for nearly half a century.  It is also anticipated that the Trump Administration will seek to eliminate the Affordable Care Act’s no-cost birth control mandate. Walker noted that “In the past five years most of the slippage on reproductive health has occurred at the state level, but in 2017 the battle shifts to the new Administration and Congress. In addition to cuts in family planning, we could see the elimination of comprehensive sex education in the schools and a return to ineffective ‘abstinence only’ programs.” 

Walker called this year’s report card  “an urgent call to action” for anyone who is concerned about reproductive health and rights. “The slippage is turning into a free fall.”


For a copy of the report, including a state-by-state breakdow: visit (

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

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