The status of reproductive health and rights in the U.S. is at an historic crossroads. At the federal level, the Affordable Care Act is expanding insurance coverage for reproductive health services, but at the state level political assaults on Planned Parenthood and other providers are threatening to limit access to family planning clinics. What happens in the next few years could dramatically affect the future status of reproductive health and rights in the U.S.
If the Affordable Care Act survives and more states expand Medicaid eligibility, the costs of accessing contraceptive services could be dramatically lower for most women, but if the state assault on family planning providers continues unabated and the courts do not rein in the growing number of abortion restrictions, many women will find it more difficult to gain physical access to family planning and abortion services. Because of these two conflicting trends, the United States as a whole received the same grade for 2013, a "C-", as it did the prior year, but several states saw their grades decline as a result of abortion restrictions or cutbacks in support for family planning services.