Trends in Uninsured Clients Visiting Health Centers Funded by the Title X Family Planning Program — Massachusetts, 2005–2012

In 2006, Massachusetts passed legislation that broadened access to health insurance for its residents. The percentage of the state population that had health insurance (obtained through either private insurance or publicly funded programs) subsequently increased, reaching 97% in 2011, leaving only 3% uninsured, compared with approximately 9%-20% uninsured among nonelderly residents in 2006. Given such high rates of insurance coverage, questions arise about the need for categorical public health programs designed to serve clients without health insurance. This report describes trends in the percentage of uninsured clients seen at community-based organizations in Massachusetts that received federal funding for one such program, the Title X family planning program. Title X program data from 2005-2012 indicate that client volume remained high throughout the period, and that the percentage of clients who were uninsured declined, from 59% in 2005 to 36% in 2012. Across years, young adults aged 20-29 years and persons whose incomes were 101%-250% of the federal poverty level were more likely to be uninsured than were persons in other age and income groups. After health-care reform, publicly funded family planning services in Massachusetts saw continued demand from uninsured and insured clients. Family planning services in other states implementing health-care reform might have a similar experience, and public health agencies are encouraged to track such trends to monitor the demand for such services and inform budget planning and resource allocation.