ArticleMedical care2019
Medicaid Expansion at Title X Clinics: Client Volume, Payer Mix, and Contraceptive Method Type.
Article in Medical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Declines in HIV testing and diagnoses: a policy analysis of the 2019 Title X federal regulations on family planning clinics.Sexual and reproductive health matters · 2025Article
- Study protocol: ACCESS: (Advancing Contraceptive Equity and Service Uptake through Telemedicine in the US Safety-Net).Research square · 2025Article
- State-level trends in access to Medicaid family planning services, 2008-2023.Health services research · 2025Article
- Medicaid Expansion And Outpatient Cardiovascular Care Use Among Low-Income Nonelderly Adults, 2012-15.Health affairs (Project Hope) · 2023Article
- Postpartum Contraceptive Use, Pregnancy Intentions in Women With and Without a Delivery of a NAS-Affected Infant in Delaware, 2012-2018.Delaware journal of public health · 2023Article
- Pathways to reproductive autonomy: Using path analysis to predict family planning outcomes in the United States.Health & social care in the community · 2022Article
- Accessibility of federally funded family planning services in South Carolina and Alabama.Preventive medicine reports · 2021Article
- Evaluation of Medicaid Expansion Under the Affordable Care Act and Contraceptive Care in US Community Health Centers.JAMA network open · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundTitle X supports access to family planning and preventive care services. Given its focus on low-income clients, Title X clinics may have been particularly affected by the Affordable Care Act's Medicaid expansion.
objectivesTo examine the impact of the Affordable Care Act's Medicaid expansion on Title X client volumes, health insurance coverage, and contraceptive method mix. RESEARCH
designA difference-in-differences design compared changes in the outcomes of interest before and after expansion, for expansion versus nonexpansion states. SUBJECTS: Administrative data from Family Planning Annual Reports that describe Title X clients who sought services. MEASURES: Female client volume was measured using a participation ratio defined as the number of female clients per 100 women aged 15-44 with incomes <250% of the federal poverty line. We also examined the share of clients by insurance type and contraceptive method type.
resultsWe did not find evidence that expansion was related to changes in client volume. We did find a significant 9.9 percentage point increase in the share of clients with Medicaid and a significant 10.0 percentage point decrease in the share of clients without coverage. We found suggestive evidence that expansion was associated with increased use of long-acting reversible contraceptives, but those results were somewhat sensitive to model specification.
conclusionsExpansion was associated with meaningful increases in Medicaid coverage at Title X clinics and declines in uninsurance. Our results have important implications for the financial stability of Title X clinics in light of historical declines in Title X grant revenues.
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