Medicaid Cuts Would Devastate Sexual and Reproductive Health Care Access

Medicaid is essential to the health of the nation, covering one out of five people. It finances more than 40% of all births and accounts for 75% of all public dollars spent on family planning. Thanks to the Affordable Care Act, the overwhelming majority of states have expanded Medicaid, covering adults of reproductive age that used to fall through the cracks. Put simply, Medicaid is absolutely critical for sexual and reproductive health care. 

Medicaid is under threat. Lawmakers are rushing to cut the program to help pay for tax breaks for wealthy donors and corporations and to expand immigration enforcement and surveillance. As Congress weighs hundreds of billions of dollars in potential Medicaid cuts, advocates for sexual and reproductive health, rights, and justice must act to protect a program that supports more than 70 million people—including over 10 million of reproductive age. Proposals like work requirements, per capita caps, rolling back Medicaid expansion, ending provider taxes, lowering the federal funding match (FMAP), or repealing key regulations all threaten the program. Any of these cuts would severely reduce access to sexual and reproductive health care.

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Taking points for reaching policymakers who are NOT sexual and reproductive health champions 

• If Republicans push through these cuts, states will be forced to slash Medicaid eligibility, services, or provider reimbursement rates, exacerbating the maternal health crisis and hurting families. 

• Republican proposals could force some states to try to end Medicaid expansion, risking increases in maternal mortality and worsening child health outcomes. 

• States might have to scale back eligibility thresholds for pregnancy-based Medicaid, making it harder for people to access affordable and high-quality health services during pregnancy. 

• States could also roll back or put limits on Medicaid 12-months postpartum coverage, which has already proven to be effective in curtailing the maternal mortality rate in the country. 

• We are already seeing an alarming increase in closures of maternity care units as well as labor and delivery wings, especially in rural hospitals. Any threats to Medicaid will exacerbate existing problems with the shortage of Medicaid providers, including those that provide maternal health care and care for babies.



• States could also be forced to eliminate Medicaid benefits such as doula care or additional perinatal services for pregnant people. 

Additional talking points for policymakers who ARE sexual and reproductive health champions

• Medicaid covers one in five women and 1.2 million LGBTQI+ adults, many of whom are people of color, young people, or people with disabilities. 

• As the cornerstone of publicly funded family planning care for decades, Medicaid provides essential coverage for preventive services like contraception, cancer screenings, as well STI testing and treatment.

• Medicaid is also the leading source of coverage for people with HIV, and Medicaid expansion has been particularly critical in making progress toward ending the HIV epidemic. 

• Attempts to cut Medicaid through work requirements and other mechanisms will only serve to further efforts to all-but-eliminate sexual and reproductive health care access in the United States.



• States might also attempt to restrict benefits, such as overturning the long-standing prohibition on cost-sharing for family planning, narrowing coverage of maternal health services, or dropping or setting limits on prescription drug coverage. 

Sexual & Reproductive Health Medicaid Defense Resources

• Proposed Medicaid Work Requirements Are Another Dangerous Attack on Sexual and Reproductive Health Care Access

• Protect Medicaid Funding: Pregnant People

• Protect Medicaid Funding: Access to Sexual and Reproductive Health Care

• National Coalition for Gender Justice in Health Policy Calls on Congress to Protect Medicaid



• What Proposed Cuts to Medicaid Would Mean For Sexual and Reproductive Health, rePROs Fight Back Podcast

Medicaid Action Month             

The fight to protect Medicaid has never been more urgent. Right now, proposals to slash funding, impose harsh work requirements, and restrict eligibility threaten to destroy Medicaid and strip life-saving healthcare from millions of children, workers, older adults, and families. We won’t stand by while access to care is torn away. Join NHeLP today to stop the reckless and deadly policies and defend the rights of those who rely on Medicaid to access health care. Join the Medicaid Defense movement and support NHeLP for Medicaid Action Month.