Public expenditures for family planning services totaled $2.1 billion in fiscal year 2015, and Medicaid accounted for three-quarters of those expenditures, according to a new Guttmacher Institute report.

A 2015 survey of health, social services and Medicaid agencies in all 50 states and the District of Columbia—combined with federal funding data from the Centers for Medicare and Medicaid Services and with data from private, nonprofit Title X grantees—found that Medicaid accounted for 75% of all publicly funded family planning expenditures, while state-only sources accounted for 13% and Title X funding for 10%. Other federal funding sources, including federal block grants, accounted for 2% of the total.  

Twenty percent of U.S. women of reproductive age were enrolled in Medicaid in 2015, including almost half of those living below the federal poverty level (currently $20,420 for a family of three). Many states expanded Medicaid eligibility after the Affordable Care Act’s implementation. Largely as a result of these expansions, the number of reproductive-age women enrolled in Medicaid increased by 24% nationally between 2013 and 2015.

The study also looked at public funding for abortion and found that, in 2015, states spent $71 million on about 157,000 abortion procedures for low-income women. The federal government—which restricts funding to cases that threaten the life of the woman or are the result of rape or incest—contributed to the cost of only 160 of these procedures. Nearly all publicly funded abortions in 2015 occurred in the 17 states that allow state Medicaid funds to pay for most or all medically necessary abortions.