The Trump administration is taking steps to limit family planning services both domestically and internationally. When the most drastic Medicaid cuts in the One Big Beautiful Bill Act take effect at the end of next year and Affordable Care Act premium subsidies expire at the end of 2025, many low-income American women of reproductive age could lose access to birth control along with other health services.
Specific actions include an initial rollback of Title X funding for family planning, the firing of a CDC team that oversees and updates guidance on contraceptive options for doctors, and the blocking of Medicaid payments to Planned Parenthood. The abrupt shutdown of USAID ends U.S. support for a broad range of global health programs, including family planning. Rather than distribute or sell a stockpile of contraceptive products purchased for women and girls in low-income countries, the administration plans to destroy it. As unintended pregnancies rise, so will rates of maternal and infant mortality and healthcare spending.
Family Planning Is Effective And Popular
Polls consistently show broad support for family planning across both political parties. The U.S. Centers for Disease Control considers it one of the 20th century’s 10 “great public health achievements.”
Access to birth control reduces maternal mortality, increases female participation in the workforce and enhances women’s economic self-sufficiency. Enabling mothers to space out the births of their children also benefits maternal and child health, according to the American College of Obstetricians and Gynecologists.
Studies have found that universal coverage of contraceptives is cost-effective ($6 saved for every dollar spent) and reduces abortion rates. Nearly all U.S. women who have been sexually active (99%) report having used some form of contraception, and 87.5% report use of a highly effective reversible method such as birth control pills, an injectable method, a contraceptive patch or an intrauterine device.
Family Planning Cuts Could Turn Back The Clock
Before the Supreme Court intervened in 1965, married women in some states weren’t legally allowed to use contraception. Four years later, Richard Nixon wrote to Congress: “It is my view that no American woman should be denied access to family planning assistance, because of her economic condition.” The following year, Title X was enacted. Until recently, it was supported by both Republican and Democratic administrations.
The 2025 federal budget allocated $285.6 million in Title X funds to provide family planning services to low-income Americans. However, the Department of Health and Human Services recently notified more than 800 family planning sites that it is withholding their Title X funding because they “violated the Civil Rights Act and Executive Orders issued by President Trump.” The cuts jeopardize access to birth control and other health services for more than 800,000 patients nationwide. After 15 public health organizations filed suit against the administration, some clinics were notified that their funding will be restored, according to NPR.
In April, HHS fired the CDC work group that compiles and updates the “U.S. Medical Eligibility Criteria for Contraceptive Use.” American and overseas clinicians routinely use them to determine the best contraceptive methods for persons with certain characteristics or health conditions. It’s unclear how this vital resource will be maintained without a dedicated team to do it.
Medicaid Cuts Will Reduce Access to Family Planning
The One Big Beautiful Bill Act, which Trump is trying to rebrand as polls highlight its unpopularity, makes severe cuts to Medicaid, but most won’t take effect until after the mid-term elections in November 2026. In addition, ACA marketplace subsidies are set to expire at the end of the year. Millions of low-income Americans who lose either form of coverage will struggle to get care.
Trump’s tax law also includes a provision that blocks further Medicaid payments to Planned Parenthood. In late July, a federal judge ruled it unconstitutional. If the judge’s ruling is overturned on appeal, 200 Planned Parenthood health centers in 24 states could close.
International Family Planning Hit
The dismantling of the U.S. Agency for International Development in early 2025 dealt a body blow to foreign aid. In late July, the State Department disclosed that it intends to destroy nearly $10 million worth of taxpayer-funded birth control products previously purchased for women and girls in low-income countries. The stockpile — including IUDs, implants and birth control pills — is currently stranded in a Belgian warehouse, according to NPR.
Although none of the products expire before 2027, and some are good until 2031, the administration plans to spend $167,000 to have them incinerated in Europe. Several humanitarian organizations offered to purchase the stockpile, but were rejected. In a statement provided to NPR, a State Department spokesperson described the products as “abortifacient birth control commodities” even though they prevent pregnancies rather than end them. Misrepresentations of this sort are growing more common as disinformation about obstetric and gynecologic care spreads on social media.
The administration’s plan to incinerate birth control products is reminiscent of its recent decision to destroy about 500 tons of high-energy, nutrient-dense biscuits stockpiled for famine relief rather than transfer them to a friendly government or non-governmental organization to feed starving children. Unfortunately, consideration of that option was delayed by USAID staff cuts, Department of Government Efficiency policies and other hurdles. As a result, the administration did not act before the food expired.
Avril Benoît, CEO of Médecins Sans Frontières’ U.S. offices, is indignant. “Destroying valuable medical items that were already paid for by U.S. taxpayers does nothing to combat waste or improve efficiency,” she said. “This administration is willing to burn birth control and let food supplies rot, risking people’s health and lives to push a political agenda.”
A Familiar Playbook
Some health experts see parallels between administration efforts to limit family planning and ongoing efforts to restrict abortions. In March, the Trump administration dropped the Biden administration’s legal challenge to Idaho’s abortion ban because it violates the Emergency Medical Treatment and Active Labor Act, a 1986 law that asserts patients who come to an ER with an emergency condition cannot be denied needed care. In July, the administration rescinded 2022 federal guidance that EMTALA entitles a woman in any state to receive an abortion if the procedure is necessary to save her life. Voiding this guidance increases the risk that ER doctors and OB-GYN specialists in states with bans could face prosecution if they provide a woman with life-threatening complications of pregnancy the care she needs.
What’s Next?
Americans spend more on healthcare than citizens of any other country, but we have the highest rate of maternal mortality among high-income nations. Maternal mortality among Black Americans has reached crisis proportions. U.S. infant mortality is also high. Currently, the United States ranks 33rd out of 38 OECD countries. Mississippi last week declared a public health emergency due to the state’s alarmingly high infant mortality rate.
If we restrict access to birth control at home and abroad and disinformation about contraception spreads unchecked on social media, rates of maternal and infant death will rise, as will healthcare spending. These consequences will not be limited to the poor, the uneducated or minority groups. Every segment of society will be affected. What happens next is up to us.