21.4M Women in U.S. Face Limited Access to Subsidized Birth Control

A new analysis reveals 21.4 million US women require subsidized birth control in counties with limited access.

September 16, 2026

In the United States, a significant number of women face barriers to accessing affordable birth control, despite living in an era of significant medical advancements. A recent study conducted by two leading reproductive policy organizations, Power to Decide and the Guttmacher Institute, reveals that approximately 21.4 million women in the country require subsidized contraception but reside in areas with limited access.

This comprehensive analysis, shared exclusively with NPR, highlights the persistent issue of “contraception deserts” across the nation. These findings are depicted through two interactive, county-level maps, updating an initiative first introduced by Power to Decide in 2017. As Rachel Fey, head of state and federal policy work at Power to Decide, explains, the maps aim to offer a more accurate representation of the obstacles many individuals face, particularly those from lower-income backgrounds or rural areas.

An interactive map from Power to Decide shows to what degree publicly-funded contraceptive services meet local needs. Counties in red have the highest access, according to this analysis, and the lightest yellow counties have the lowest. In the counties in gray, no publicly-funded clinics offer contraceptive services.

A Closer Look at Access Gaps

In Maricopa County, Arizona, for instance, there are 29 clinics funded for family planning services, yet they meet only 8% of the demand for the nearly 300,000 women who need subsidized birth control. Wendy Redford, Chief Clinical Officer of Wesley Community & Health Center in Phoenix, notes that the gap is particularly evident among groups with lower resources. Despite being a large city, accessing care without insurance or Medicaid remains a significant challenge.

The interactive maps from Power to Decide show state- and county-level details about the available clinics and the population in need of subsidized birth control. With only 8% of the need being met in Maricopa County, researchers consider it to have an "extreme" birth control access gap. — The interactive maps from Power to Decide show state- and county-level details about the available clinics and the population in need of subsidized birth control. With only 8% of the need being met in Maricopa County, researchers consider it to have an “extreme” birth control access gap.

Despite these challenges, Wesley Community & Health Center strives to provide a comprehensive range of birth control options to low-income and uninsured individuals, supported by federal Title X funding. Wendy Redford emphasizes the importance of discussing birth control options at every patient visit, recognizing its potential to significantly impact women’s lives.

Developing a New Methodology

In collaboration with Guttmacher Institute, Power to Decide developed a new methodology to assess clinic capacity and demand for contraceptive services across various counties. Megan Kavanaugh, principal data researcher at Guttmacher, explains that the maps illustrate access to clinics that receive federal or state funding to provide contraceptive care. Using national surveys, they identified women with a “self-defined need” for contraception and determined the clinics’ capacity based on patient caseloads.

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According to Kavanaugh, approximately 21.4 million women live in counties where the availability of affordable contraceptive care is insufficient to meet their needs. This number underscores the critical situation, painting a “dire” picture of access to necessary services.

In Arizona, there is at least one publicly-funded clinic in each county that provides family planning services, but all counties also demonstrate an access gap.

A Call for Action

Rachel Fey from Power to Decide argues for increased funding for Title X, which has remained flat for over a decade, to better meet the demand for family planning services. She emphasizes the need for $700 million to adequately address the existing gaps in contraceptive access. The organization plans to use the updated maps to advocate for policy changes and additional resources to improve access to birth control.

Wendy Redford at Wesley Community & Health Center identifies several factors contributing to Maricopa County’s unmet contraceptive needs, including a lack of sex education and awareness about available subsidized birth control options. She stresses the importance of outreach and education to ensure individuals are aware of their options and can access the care they need.

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