Access to contraception is fundamental to reproductive autonomy and economic mobility for parents and their children. Today in the U.S., the cost of contraception severely limits access for those without health insurance. Although the Affordable Care Act eliminated cost-sharing for contraception for those with health insurance, substantial cost-sharing remains for uninsured individuals who seek care through Title X—a national family planning program that offers patient-centered, subsidized contraception and reproductive health services to low-income individuals. I propose two changes to Title X to increase the affordability of contraception for uninsured Americans: (1) make contraceptives free for low-income clients through a change to the guidelines issued by the Office of Population Affairs and Health and Human Services and (2) increase congressional appropriations for the Title X program to fund this change in guidelines. Similar to the Affordable Care Act's elimination of cost-sharing for contraception for Americans with health insurance, this proposal eliminates cost-sharing requirements for contraception for uninsured, low-income Americans through the Title X program. This policy proposal is supported by highly relevant evidence from a randomized control trial conducted at Title X providers. Eliminating costsharing for contraception through Title X would increase use of preferred contraceptive methods; reduce pregnancies that are mistimed or not desired, including those ending in abortion; and generate substantial enough savings in other government spending that the program would more than pay for itself
