Few clinicians provide a wide range of contraceptive methods to Medicaid beneficiaries

Sep 30, 2026

Access to contraception services is essential for reproductive autonomy, yet low-income individuals often face barriers, including shortages of providers who accept Medicaid and offer contraception. Using 2021 Transformed Medicaid Statistical Information System Prescription and Other Service files, the study identified clinicians delivering contraception to female Medicaid beneficiaries aged 15–44. Only 34.6% provided at least one method, and 3.9% provided prescriptions, IUDs, and implants. County variation shows advanced practice clinicians prescribing more than physicians where physician access is limited.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Introduction

Methods

Results

Key Points

Conclusion

Few clinicians provide a wide range of contraceptive methods to Medicaid beneficiaries Julia Strasser*, Taylor Gorak, Sara Luckenbill, Yoon Hong Park, Qian Luo Fitzhugh Mullan Institute for Health Workforce Equity, George Washington University, Washington, DC 20037, United States *Corresponding author: Fitzhugh Mullan Institute for Health Workforce Equity, George Washington University, 2175K Street NW, Suite 250, Washington, DC 20037, United States. Email: [jstrasser@gwu.edu](jstrasser@gwu.edu) Abstract Introduction: Access to contraception services is an essential component of reproductive autonomy; however, low-income individuals frequently face barriers to care, including a shortage of providers who both accept Medicaid and offer contraception services. Methods: We used 2021 Transformed Medicaid Statistical Information System Prescription and Other Service files to identify clinicians who provided contraception (prescription, implant, and/or intrauterine device (IUD)) to Medicaid beneficiaries. Results: We identified 523 077 primary care and women’s health specialty clinicians (obstetrician–gynecologists, family medicine, internal medicine, pediatrics, nurse practitioners, physician assistants, and midwives) who provided care to reproductive aged (15–44 years) female Medicaid beneficiaries for any service; of these, only 181 019 (34 .6%) provided at least one contraception method to Medicaid beneficiaries and even fewer 20 160 (3 .9%) provided prescriptions (pill, patch, and/or ring), IUDs, and implants. Over half (54%) of US counties had greater or equal numbers of advanced practice clinicians—nurse practitioners, physician assistants, and midwives—prescribing contraception compared with physicians. Conclusion: Few clinicians provided a wide range of contraception to Medicaid beneficiaries. Advanced practice clinicians are important providers in counties with limited access to physicians. Documenting workforce variation for contraception care has important implications for access, especially as recent policy changes may make contraception less accessible for Medicaid beneficiaries. Key words: contraception; Medicaid; workforce. Key Points • Out of 523 077 primary care and women’s health clinicians who provided care to Medicaid beneficiaries, only 181 019 (34.6%) provided at least one contraception method to reproductive aged (15–44 years) Medicaid beneficiaries and 20 160 (3.9%) provided prescription contraception (pill, patch, and/or ring), IUD, and implant. • Over half (54%) of US counties had a greater or equal number of advanced practice clinicians—nurse practitioners, physician assistants, and midwives—prescribing contraception compared with physicians. Introduction Access to contraception services is an essential component of reproductive autonomy. The ability to use one’s preferred contraceptive method enables individuals to determine family size and birth spacing, which in turn leads to improved health outcomes, better quality of life, and higher economic and educational attainment.1 However, many individuals face barriers to contraception care, with low-income individuals facing disproportionate burdens. Medicaid covers more than 71 million low-income individuals and is one of the largest payers of contraception care,2,3 but often falls short in ensuring timely access: beneficiaries frequently struggle to find physicians who accept Medicaid and experience longer wait times than those with private insurance.4,5 Providing a wide range of contraception care is an important measure of access to high-quality care. While prescription contraception methods (the contraceptive pill, patch, and ring) are common and highly effective methods of contraception, with approximately 10 million users annually,6 many contraceptive users report they would prefer a different method than the one they currently use, with over 25% in a recent study currently using the pill, patch, or ring and wanting to use

FAQs

What question does the study address about contraception access for Medicaid beneficiaries?

It examines whether clinicians who serve Medicaid beneficiaries provide a wide range of contraception methods and how this varies by geography and clinician type.

How did the researchers identify clinicians providing contraception?

The study used 2021 Transformed Medicaid Statistical Information System Prescription and Other Service files to find clinicians who provided prescription, implant, and/or IUD contraception to Medicaid beneficiaries.

What were the main findings about how many clinicians provide contraception methods?

Among 523,077 clinicians serving female Medicaid beneficiaries aged 15–44, 34.6% provided at least one contraception method, and 3.9% provided prescriptions (pill/patch/ring), IUDs, and implants.

How did provider type relate to contraception prescribing across counties?

Over half of US counties (54%) had at least as many advanced practice clinicians prescribing contraception as physicians, highlighting their importance where physician access is limited.

Sep 30, 2026

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