Few clinicians provide a wide range of contraceptive methods to Medicaid beneficiaries

Access to contraception services is an essential component of reproductive autonomy; however, low-income individuals frequently face barriers to care, including a shortage of providers who both accept Medicaid and offer contraception services.

We used 2021 Transformed Medicaid Statistical Information System Prescription and Other Service files to identify clinicians who provided contraception (prescription, implant, and/or intrauterine device (IUD)) to Medicaid beneficiaries.

We identified 523 077 primary care and women's health specialty clinicians (obstetrician-gynecologists, family medicine, internal medicine, pediatrics, nurse practitioners, physician assistants, and midwives) who provided care to reproductive aged (15-44 years) female Medicaid beneficiaries for any service; of these, only 181 019 (34.6%) provided at least one contraception method to Medicaid beneficiaries and even fewer 20 160 (3.9%) provided prescriptions (pill, patch, and/or ring), IUDs, and implants. Over half (54%) of US counties had greater or equal numbers of advanced practice clinicians-nurse practitioners, physician assistants, and midwives-prescribing contraception compared with physicians.

Few clinicians provided a wide range of contraception to Medicaid beneficiaries. Advanced practice clinicians are important providers in counties with limited access to physicians. Documenting workforce variation for contraception care has important implications for access, especially as recent policy changes may make contraception less accessible for Medicaid beneficiaries.