ASPPH logo


Member Research & Reports

Member Research & Reports

Maryland: Researchers Examine Medicaid Expansion’s Effect on Family Planning Clinics

The Affordable Care Act’s Medicaid expansion helped more clients visiting Title X family planning clinics receive public insurance coverage, according to new research conducted by the University of Maryland School of Public Health and published in Medical Care.

That increased coverage can offset the declining Title X grant money these clinics receive, the study suggests, helping them maintain service levels for low-income families and see more clients.

The study also examined the effect of Medicaid expansion on patient totals and contraceptive methods used by female clients. Surprisingly, Medicaid expansion was not associated with an increase in total clients visiting Title X clinics, suggesting that lack of coverage is not an obstacle to receiving care. But expansion was associated with increased use of long-acting reversible contraceptives, including implants and intrauterine devices, though the results were somewhat sensitive to the statistical model used.

The study was conducted by assistant professor Dr. Michel Boudreaux from the Department of Health Policy and Management,  Ms. Yoon Sun Choi, Dr. Liyang Xie and Mr. Daniel Marthey. Dr. Boudreaux’s research focuses on publicly financed health programs for low-income populations and their effect on health, human capital and socioeconomic status.

To conduct the study, Dr. Boudreaux and his team analyzed state-level data on Title X clinic usage from the Family Planning Annual Reports compiled by the U.S. Department of Health and Human Services.

The Title X program provides low-income families with access to reproductive health services, but Title X grants have declined since the 2000s. The results suggest that Medicaid expansion offers another way for Title X clinics to maintain financial stability.