Center for American Progress

Project 2025 Would Take Away Access to Free Emergency Contraception for 48 Million Women
Article

Project 2025 Would Take Away Access to Free Emergency Contraception for 48 Million Women

A new state-by-state analysis estimates that 48 million women would lose guaranteed access to no-cost emergency contraception if the Project 2025 agenda were implemented.

Part of a Series
Photo shows a purple/white box of the Ella pill
The emergency contraception pill Ella sits on a white surface, August 2012. (Getty/BSIP/UIG )

This article is part of a series of work from the Center for American Progress exposing how the sweeping, far-right Project 2025 policy agenda would harm all Americans. This new authoritarian playbook published by the Heritage Foundation would destroy the 250-year-old system of checks and balances upon which U.S. democracy has relied and give politicians, judges, and corporations more control over Americans’ lives.

For more than a decade, most people have been able to access contraception and other preventive health services at no cost. This guaranteed coverage has been a lifeline for millions of women. But extremists want to restrict women’s access to contraception—limiting their right to control their own futures.

In “Project 2025: A Presidential Transition Project,” far-right extremists outline their intent to exclude some forms of emergency contraception from no-cost coverage. The Affordable Care Act (ACA) requires most private health insurance plans to provide no-cost coverage—without copayment, coinsurance, or deductible—for recommended preventive services. This benefit includes the full range of U.S. Food and Drug Administration-approved birth control methods and counseling, including emergency contraception. Rescinding no-cost coverage could have lifelong consequences for women nationwide. A new Center for American Progress analysis estimates that if Project 2025 were enacted, nearly 48 million women of reproductive age would lose their guaranteed no-cost access to emergency contraception.

It is unlikely that restrictions on contraception would end here.

Without guaranteed no-cost coverage, millions of women may not have access to emergency contraception when they need it. According to a national survey, nearly one-quarter of reproductive-age women who have ever had sex with a man report having used emergency contraception at some point. In other words, nearly 10 million women with guaranteed free contraception coverage today have used emergency contraception at some point in the past.

Under Project 2025, millions of women would lose emergency contraception (EC) coverage

  • United States (choose a state)

75.42M

Number of women aged 15–49

47.8M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

9.72M

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.15M

Number of women aged 15–49

754K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

153K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

162K

Number of women aged 15–49

95K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

59%

Proportion of reproductive-age women who could lose EC coverage

19K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.64M

Number of women aged 15–49

981K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

60%

Proportion of reproductive-age women who could lose EC coverage

199K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

672K

Number of women aged 15–49

378K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

56%

Proportion of reproductive-age women who could lose EC coverage

77K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

9.13M

Number of women aged 15–49

5.56M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

61%

Proportion of reproductive-age women who could lose EC coverage

1.13M

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.38M

Number of women aged 15–49

910K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

66%

Proportion of reproductive-age women who could lose EC coverage

185K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

807K

Number of women aged 15–49

518K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

105K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

216K

Number of women aged 15–49

138K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

28K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

199K

Number of women aged 15–49

140K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

70%

Proportion of reproductive-age women who could lose EC coverage

28K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

4.69M

Number of women aged 15–49

2.99M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

607K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.61M

Number of women aged 15–49

1.66M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

336K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

299K

Number of women aged 15–49

193K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

39K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

434K

Number of women aged 15–49

290K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

67%

Proportion of reproductive-age women who could lose EC coverage

59K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.86M

Number of women aged 15–49

1.85M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

375K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.53M

Number of women aged 15–49

990K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

201K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

700K

Number of women aged 15–49

478K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

68%

Proportion of reproductive-age women who could lose EC coverage

97K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

653K

Number of women aged 15–49

449K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

69%

Proportion of reproductive-age women who could lose EC coverage

91K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

998K

Number of women aged 15–49

582K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

58%

Proportion of reproductive-age women who could lose EC coverage

118K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.04M

Number of women aged 15–49

555K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

53%

Proportion of reproductive-age women who could lose EC coverage

113K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

280K

Number of women aged 15–49

181K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

37K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.39M

Number of women aged 15–49

930K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

67%

Proportion of reproductive-age women who could lose EC coverage

189K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.61M

Number of women aged 15–49

1.12M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

70%

Proportion of reproductive-age women who could lose EC coverage

228K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.19M

Number of women aged 15–49

1.38M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

280K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.25M

Number of women aged 15–49

861K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

69%

Proportion of reproductive-age women who could lose EC coverage

175K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

675K

Number of women aged 15–49

410K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

61%

Proportion of reproductive-age women who could lose EC coverage

83K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.37M

Number of women aged 15–49

928K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

68%

Proportion of reproductive-age women who could lose EC coverage

189K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

240K

Number of women aged 15–49

151K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

31K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

442K

Number of women aged 15–49

308K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

70%

Proportion of reproductive-age women who could lose EC coverage

63K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

722K

Number of women aged 15–49

426K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

59%

Proportion of reproductive-age women who could lose EC coverage

87K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

291K

Number of women aged 15–49

211K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

72%

Proportion of reproductive-age women who could lose EC coverage

43K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.05M

Number of women aged 15–49

1.36M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

67%

Proportion of reproductive-age women who could lose EC coverage

277K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

465K

Number of women aged 15–49

221K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

47%

Proportion of reproductive-age women who could lose EC coverage

45K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

4.46M

Number of women aged 15–49

2.78M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

62%

Proportion of reproductive-age women who could lose EC coverage

566K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.45M

Number of women aged 15–49

1.56M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

318K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

174K

Number of women aged 15–49

126K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

72%

Proportion of reproductive-age women who could lose EC coverage

26K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.57M

Number of women aged 15–49

1.62M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

330K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

918K

Number of women aged 15–49

529K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

58%

Proportion of reproductive-age women who could lose EC coverage

108K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

958K

Number of women aged 15–49

614K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

125K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

2.81M

Number of women aged 15–49

1.89M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

67%

Proportion of reproductive-age women who could lose EC coverage

385K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

247K

Number of women aged 15–49

165K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

67%

Proportion of reproductive-age women who could lose EC coverage

34K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.17M

Number of women aged 15–49

733K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

149K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

188K

Number of women aged 15–49

132K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

70%

Proportion of reproductive-age women who could lose EC coverage

27K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.6M

Number of women aged 15–49

1.01M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

63%

Proportion of reproductive-age women who could lose EC coverage

205K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

7.22M

Number of women aged 15–49

4.29M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

59%

Proportion of reproductive-age women who could lose EC coverage

872K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

845K

Number of women aged 15–49

623K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

74%

Proportion of reproductive-age women who could lose EC coverage

127K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

139K

Number of women aged 15–49

89K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

64%

Proportion of reproductive-age women who could lose EC coverage

18K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.99M

Number of women aged 15–49

1.29M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

65%

Proportion of reproductive-age women who could lose EC coverage

262K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.8M

Number of women aged 15–49

1.18M

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

66%

Proportion of reproductive-age women who could lose EC coverage

240K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

367K

Number of women aged 15–49

212K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

58%

Proportion of reproductive-age women who could lose EC coverage

43K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

1.27M

Number of women aged 15–49

874K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

69%

Proportion of reproductive-age women who could lose EC coverage

178K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

124K

Number of women aged 15–49

85K

Number of reproductive-age women who could lose guaranteed no-cost EC coverage

68%

Proportion of reproductive-age women who could lose EC coverage

17K

Number of reproductive-age women who wouldn't have been guaranteed no-cost EC when they needed it

Note: The U.S. totals may not sum due to rounding.

Sources: U.S. Census Bureau, "American Community Survey (ACS)," available at https://www.census.gov/programs-surveys/acs (last accessed June 2024); Kimberly Daniels and Joyce C. Abma, "Contraceptive Methods Women Have Ever Used: United States, 2015-2019," National Health Statistics Report 195 (2023), available at https://www.cdc.gov/nchs/data/nhsr/nhsr195.pdf; Gary Claxton and others, "Employer Health Benefits 2020 Annual Survey" (San Francisco: KFF, 2020), available at https://files.kff.org/attachment/Report-Employer-Health-Benefits-2020-Annual-Survey.pdf.

Make no mistake: Project 2025 isn’t just about preventive care coverage. It is another attempt by right-wing extremists to undermine women’s bodily autonomy. Emergency contraception is completely safe and effective at preventing a pregnancy before it occurs, and extremists want to take this option away. It is unlikely that restrictions on contraception would end here: Bills introduced in the past two years in Louisiana and Oklahoma would restrict access to several types of emergency contraception, including some intrauterine devices (IUDs).

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Methodology

The authors used 2022 data from the American Community Survey to estimate the number of women of reproductive age (defined as ages 15 to 49) with employer-sponsored insurance (46 million nationally) or direct purchase insurance in each state and the District of Columbia. The authors assumed that the 8.2 million women with direct purchase insurance were in qualified health plans subject to the ACA’s no-cost preventive service coverage guarantee. The authors subtracted the number of reproductive-age women with employer-sponsored insurance plans that are “grandfathered” and exempt from the preventive service coverage guarantee using a 14 percent estimate from the 2020 KFF Employer Health Benefits Annual Survey, the most recent data point available. That resulted in an estimate of 47.8 million total women of reproductive age in private plans with guaranteed no-cost contraception coverage.

The authors then applied national estimates from the National Survey on Family Growth from 2015 to 2019 for the proportion of reproductive-age women who have had vaginal intercourse with a man (87.8 percent) and, of these, the proportion of reproductive-age women who have ever taken emergency contraception (23.5 percent) to estimate that 20.3 percent of all reproductive-age women have ever used emergency contraception. Applying that share to the total implies that 9.7 million women in plans with guaranteed no-cost contraception coverage have used emergency contraception in the past.

The authors assumed that national estimates of grandfathered plans, sexual activity, and emergency contraception use were consistent in each state. This analysis does not account for employer-based health plans with religious exemptions from covering contraception or other exclusions.

The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.

Authors

Nicole Rapfogel

Policy Analyst, Health

Kierra B. Jones

Senior Policy Analyst

Team

Health Policy

The Health Policy team advances health coverage, health care access and affordability, public health and equity, social determinants of health, and quality and efficiency in health care payment and delivery.

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