50-STATE REPORT CARD

Transcription

1 JANUARY 2014 The State of Reproductive Health and Rights: 50-STATE REPORT CARD U.S. REPRODUCTIVE HEALTH AND RIGHTS AT A CROSSROADS The status of reproductive health and rights in the U.S. is at an historic crossroads. At the federal level, the Affordable Care Act is expanding insurance coverage for reproductive health services, but at the state level political assaults on Planned Parenthood and other providers are threatening to limit access to family planning clinics. What happens in the next few years could dramatically affect the future status of reproductive health and rights in the U.S. If the Affordable Care Act survives and more states expand Medicaid eligibility, the costs of accessing contraceptive services could be dramatically lower for most women, but if the state assault on family planning providers continues unabated and the courts do not rein in the growing number of abortion restrictions, many women will find it more difficult to gain physical access to family planning and abortion services. Because of these two conflicting trends, the United States as a whole received the same grade for 2013, a C-, as it did the prior year, but several states saw their grades decline as a result of abortion restrictions or cutbacks in support for family planning services.

2 THE UNITED STATES GETS A C- The United States as a whole has been given a grade of C-. Here s why: n n n America s rate of unintended pregnancy remains stubbornly high: almost half of all pregnancies in the U.S. are unintended. Many of the gains that have been made in reproductive health could be reversed if social conservatives prevail in Congress and the state legislatures. Family planning clinics are being threatened by funding cuts and burdensome laws and regulations. GRADING REPRODUCTIVE HEALTH AND RIGHTS While most Americans are aware of the national political debate over birth control and abortion, many are uninformed about the status of reproductive health and rights in their own state. In the interest of an informed public debate, the Population Institute is for the second year in a row--releasing a report card that gives an overview of what s happening in the 50 States and the District of Columbia. THE 50-STATE REPORT CARD FOCUS: The 50-state report card focuses on four broad indicators or policies relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies are unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception in the emergency room? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services?

3 CRITERIA AND SCORES: Nine criteria are used in determining a state s composite score. States with the best grades will have: 1. A low rate of teenage pregnancy (15 points maximum) 2. A low rate of unintended pregnancy (15 points maximum) 3. Comprehensive sex education in the schools (15 points maximum) 4. Access to emergency contraception in the emergency room (5 points maximum) 5. Medicaid expansion under the Affordable Care Act (10 points maximum) 6. A Medicaid waiver expanding eligibility for family planning services (10 points maximum) 7. Adequate state funding for family planning clinics serving low-income households, measured by dollars of assistance per woman in need (10 points maximum) 8. An absence of burdensome abortion restrictions (10 points maximum) 9. County-level access to family planning and abortion services (10 points maximum) CORE GRADE: Each state is assigned a core grade based upon the following grading system: A: points B: points C: points D: points F: < than 45 points FINAL GRADE:If there are noteworthy developments that are not reflected in the state s core grade, a state may be accorded a plus (+) or a minus (-), depending on how the changes are likely to impact reproductive health and rights. STATE TOTAL SCORES LETTER GRADES STATE TOTAL SCORES LETTER GRADES STATE TOTAL SCORES LETTER GRADES AL 46.3 D- KY 54.3 D- ND 46.6 D- AK 47.5 D LA 37.6 F- OH 66.3 B- AZ 55.9 C ME 62.3 C OK 54.5 D- AR 54.3 D- MD 80.9 A OR 90.0 A CA 87.2 A+ MA 64.6 C PA 48.3 D CO 61.1 C MI 58.6 C RI 68.3 B CT 75.6 B MN 63.7 C- SC 65.2 B DE 74.7 B MS 34.8 F- SD 37.0 F- DC 63.9 C MO 43.8 F- TN 41.7 F FL 46.4 D MT 51.0 D- TX 41.3 F- GA 43.8 F NE 41.3 F UT 44.0 F HI 62.3 C NV 51.7 D VT 78.0 B ID 43.0 F NH 51.0 D VA 51.9 D IL 69.7 B NJ 79.6 B WA 84.1 A+ IN 38.6 F- NM 78.1 B WV 66.1 B IA 65.0 B- NY 77.1 B WI 61.0 C- KS 37.0 F- NC 65.0 B- WY 40.1 F

4 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D- Alabama is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Alabama received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Alabama s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Alabama received a D grade because: n Alabama has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, there is a mandatory ultrasound where the woman must be given an opportunity to view the image, waiting period of 24 hours between the woman receiving counseling and obtaining her abortion, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. n Alabama has no laws affirming a woman s right to emergency contraception in the emergency room. n Alabama has decided not to expand their Medicaid program under the Affordable Care Act. Alabama received a minus because of legislation passed requiring that before a patient can be prescribed a medication abortion they must be examined by a physician in person, therefore banning telemedicine. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Alabama, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

5 D- Alabama 46.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 12.5 / 15 Sex Education 7.5 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 4 / 10 Alabama has a teen pregnancy rate of 73 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Alabama has achieved 83.3% of the objective. Unintended Pregnancy Rate 12.3 / 15 52% of Alabama s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Alabama has achieved 81.8% of the target rate. Alabama requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 0 / 5 Alabama has no laws affirming a woman s right to emergency contraception in the emergency room. Alabama has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Alabama offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with an income level 133% of the federal poverty line. However, since the expansion of the Affordable Care Act would have covered people up to 138% of the poverty line Alabama does not get points for their family planning expansion. Funding for Family Planning Clinics 6 / 10 Alabama has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, there is a mandatory ultrasound where the woman must be given an opportunity to view the image, waiting period of 24 hours between the woman receiving counseling and obtaining her abortion, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 4 / 10 61% of women in Alabama live in a county without an abortion provider. Alabama spent $147 in the fiscal year 2010 on family planning services per woman in need.

6 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D Alaska is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Alaska received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Alaska s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Alaska received a D grade because: n Alaska has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: a woman planning on receiving an abortion must undergo mandatory counseling including information on a breast cancer link and fetal pain, parental notice is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. n Alaska does not mandate sex education in public schools. n Alaska has decided not to expand their Medicaid program under the Affordable Care Act and currently does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Alaska, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

7 D Alaska 47.5 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 13.5 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 6 / 10 Alaska has a teen pregnancy rate of 69 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Alaska has achieved 90% of the objective. Unintended Pregnancy Rate 14.0 / 15 Alaska does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Alaska has no laws affirming a woman s right to emergency contraception in the emergency room. Alaska has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Alaska currently does not offer an expansion for family planning services to the Medicaid plan. Alaska has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: a woman planning on receiving an abortion must undergo mandatory counseling including information on a breast cancer link and fetal pain, parental notice is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. 47% of Alaska s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Alaska has achieved 93.2% of the target rate. Funding for Family Planning Clinics 6 / 10 Alaska spent $147 in the fiscal year 2010 on family planning services per woman in need. Abortion Access 8 / 10 22% of women in Alaska live in a county without an abortion provider.

8 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Arizona is one of 9 states receiving an C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Arizona received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Arizona s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Arizona received a C grade because: n Arizona has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between preabortion counseling and undergoing the procedure, a mandatory ultrasound where the woman must be given an opportunity to view the image, parental consent is required and requires clinicians who perform medication abortion procedures to be licensed physicians. n Arizona does not mandate sex education in public schools. n Arizona has no laws affirming a woman s right to emergency contraception in the emergency room. Arizona would have received a D if the U.S. Court of Appeals for the Ninth District had not struck down Arizona s restrictive abortion law that was passed in 2012 which would have banned abortion at 18 weeks post fertilization. The court ruled that Arizona may not prevent women from terminating a pregnancy prior to viability. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

9 C Arizona 55.9 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 10.2 / 15 Arizona has a teen pregnancy rate of 82 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Arizona has achieved 68.3% of the objective. Unintended Pregnancy Rate 12.6 / 15 Sex Education 0 / 15 Arizona does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Arizona has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Arizona is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 2 / 10 Arizona does not offer a family planning expansion to its Medicaid program based on income. However their family planning program is expanded to include those under 19. Abortion Restrictions 6 / 10 Arizona has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between pre-abortion counseling and undergoing the procedure, a mandatory ultrasound where the woman must be given an opportunity to view the image, parental consent is required and requires clinicians who perform medication abortion procedures to be licensed physicians. 51% of Arizona s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Arizona has achieved 84.1% of the target rate. Funding for Family Planning Clinics 6 / 10 Arizona spent $151 in the fiscal year 2010 on family planning services per woman in need. Abortion Access 9 / 10 17% of women in Arizona live in a county without an abortion provider.

10 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D- Arkansas is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Arkansas received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Arkansas s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Arkansas received a D grade because: n Arkansas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks of pregnancy, the woman must undergo mandatory counseling including information on fetal pain after 20 weeks gestation, the woman must receive pre-abortion counseling the day before her procedure, parental consent is required, and require clinicians who perform medication abortion procedures to be licensed physicians. n Arkansas does not mandate sex education in public schools. n Arkansas has a high teen pregnancy rate of 82 pregnancies per 1,000 women aged and 57% of its total pregnancies are unintended. Arkansas received a minus because of legislation that passed their Senate this year that would prohibit the state from granting public family planning funds to organizations that provide abortion services, provide referrals for abortions, groups that contract with abortion providers, or are affiliated with organizations that provide abortions. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

11 D- Arkansas 54.3/ 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 10.2 / 15 Arkansas has a teen pregnancy rate of 82 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Arkansas has achieved 68.3% of the objective. Unintended Pregnancy Rate 10.6 / 15 57% of Arkansas s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Arkansas has achieved 70.5% of the target rate. Sex Education o / 15 Arkansas does not mandate sex education in public schools. Access to Emergency Contraception 2.5 / 5 Arkansas mandates that emergency rooms provide information about emergency contraception. Medicaid Expansion 10 / 10 Arkansas is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Arkansas offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with an income level up to 200% of the federal poverty line. Women under age 19 are also covered. Funding for Family Planning Clinics 7 / 10 Arkansas spent $152 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 4 / 10 Arkansas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks of pregnancy, the woman must undergo mandatory counseling including information on fetal pain after 20 weeks gestation, the woman must receive pre-abortion counseling the day before her procedure, parental consent is required, and require clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 3 / 10 79% of women in Arkansas live in a county without an abortion provider.

12 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- A+ California is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but California received an A+. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. California s grade, an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. California received an A grade because: n California currently does not have laws enacted that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so and only 1% of women live in a county that does not have an abortion provider. n California mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n California is expanding their Medicaid program under the Affordable Care Act and they expand Medicaid to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with incomes up to 200% of the federal poverty line. Men, as well as women under the age of 19, are also covered. California received a plus because in August it passed a law which would allow first trimester abortions to be performed by nurse practitioners, physician s assistants, and nurse-midwives after they have completed the appropriate training and certification. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

13 A+ California 87.2 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 12.7 / 15 California has a teen pregnancy rate of 72 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that California has achieved 85% of the objective. Unintended Pregnancy Rate 11.9 / 15 53% of California s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, California has achieved 79.5% of the target rate. Sex Education 7.5 / 15 California requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 5 / 5 California mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansions 10 / 10 California is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 California offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with incomes up to 200% of the federal poverty line. Men, as well as women under the age of 19, are also covered. Abortion Restrictions 10 / 10 California currently does not have laws enacted that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 10 / 10 1% of women in California live in a county without an abortion provider. Funding for Family Planning Clinics 10 / 10 California spent $245 in the fiscal year 2010 on family planning services per woman in need.

14 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Colorado is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Colorado received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Colorado s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Colorado received a C grade because: n Colorado has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: parental notice is required and requires clinicians who perform medication abortion procedures to be licensed physicians. n Colorado does not mandate sex education in public schools. n Colorado currently does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

15 C Colorado 61.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 14.2 / 15 Sex Education 0 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 8 / 10 Colorado has a teen pregnancy rate of 66 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Colorado has achieved 95% of the objective. Unintended Pregnancy Rate 14.3 / 15 46% of Colorado s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Colorado has achieved 95.5% of the target rate. Colorado does not mandate sex education in public schools. Access to Emergency Contraception 2.5 / 5 Colorado mandates that emergency rooms provide information about emergency contraception. Colorado is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansion 0 / 10 Colorado currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 4 / 10 Colorado spent $80 in the fiscal year 2010 on family planning services per woman in need. Colorado has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: parental notice is required and requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 8 / 10 23% of women in Colorado live in a county without an abortion provider.

16 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B Connecticut is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Connecticut received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Connecticut s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Connecticut received a B grade because: n Connecticut currently does not have laws enacted that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. n Connecticut mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n Connecticut is expanding their Medicaid program under the Affordable Care Act and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with incomes up to 250% of the federal poverty line. Men, as well as women under the age of 19, are also covered. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

17 B Connecticut 75.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Connecticut has a teen pregnancy rate of 55 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Connecticut has exceeded this objective. Unintended Pregnancy Rate 12.6 / 15 51% of Connecticut s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Connecticut has achieved 84.1% of the target rate. Sex Education 0 / 15 Connecticut mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 5 / 5 Connecticut mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 Connecticut is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10/ 10 Connecticut offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with incomes up to 250% of the federal poverty line. Men, as well as women under the age of 19, are also covered. Abortion Restrictions 10 / 10 Connecticut currently does not have laws enacted that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 10 / 10 5% of women in Connecticut live in a county without an abortion provider. Funding for Family Planning Clinics 3 / 10 Connecticut spent $65 in the fiscal year 2010 on family planning services per woman in need.

18 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B Delaware is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Delaware received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Delaware s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Delaware received a B grade because: n Only 19% of women in Delaware live in a county without an abortion provider. n Delaware mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Delaware is expanding their Medicaid program under the Affordable Care Act and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people who have lost coverage for up to 2 years. Women under age 19 are also covered. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. For the complete report card and additional information, please visit:

19 B Delaware 74.7 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 10.5 / 15 Sex Education 15 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 8 / 10 Delaware has a teen pregnancy rate of 81 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Delaware has achieved 69.9% of the objective. Unintended Pregnancy Rate 9.2 / 15 61% of Delaware s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Delaware has achieved 61.4% of the target rate. Delaware mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 Delaware has no laws affirming a woman s right to emergency contraception in the emergency room. Delaware is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Delaware offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people who have lost coverage for up to 2 years. Women under age 19 are also covered. Funding for Family Planning Clinics 6 / 10 Delaware requires parental notice before a woman may undergo the procedure. However, parental notice can be waived under certain circumstances. Require clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 9 / 10 19% of women in Delaware live in a county without an abortion provider. Delaware spent $143 in the fiscal year 2010 on family planning services per woman in need.

20 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Washington, D.C. is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Washington, D.C. received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Washington, D.C. s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Washington, D.C. received a C grade because: : n The District of Columbia has a very high teen pregnancy rate of 112 pregnancies per 1,000 women aged and a very high unintended pregnancy rate with 70% of the District of Columbia s total pregnancies are unintended. n The District of Columbia mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n The District of Columbia is expanding their Medicaid program under the Affordable Care Act, but does not offer an expansion of their family planning program under Medicaid. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

21 C Washington, D.C / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 2.7 / 15 Sex Education 15 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 10 / 10 The District of Columbia has a teen pregnancy rate of 112 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that the District of Columbia has achieved 18.2% of the objective.. Unintended Pregnancy Rate 6.1 / 15 70% of the District of Columbia s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, the District of Columbia has achieved 40.9% of the target rate. The District of Columbia mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 5 / 5 The District of Columbia mandates that emergency rooms provide information about emergency contraception and dispense it upon request. The District of Columbia is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 District of Columbia currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 5 / 10 The District of Columbia spent $120 in the fiscal year 2010 on family planning services per woman in need. The District of Columbia currently does not have laws enacted that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 10 / 10 0% of women in the District of Columbia live in a county without an abortion provider.

22 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D Florida is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Florida received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Florida s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Florida received a D grade because: n Florida has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, a mandatory ultrasound where the woman must be given an opportunity to view the image is required, parental notice is required before a woman can undergo the procedure, and require clinicians who perform medication abortion procedures to be licensed physicians. n Florida does not mandate sex education in public schools. n Florida has no laws affirming a woman s right to emergency contraception in the emergency room. n Florida has decided not to expand their Medicaid program under the Affordable Care Act. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Florida, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

23 D Florida 46.4 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 12.5 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 5 / 10 Florida has a teen pregnancy rate of 73 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Florida has achieved 83.3% of the objective. Unintended Pregnancy Rate 9.9 / 15 59% of Florida s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Florida has achieved 65.9% of the target rate. Florida does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Florida has no laws affirming a woman s right to emergency contraception in the emergency room. Florida has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Florida offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people who have lost coverage for up to 2 years. Women under age 19 are also covered under the expansion. Florida has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, a mandatory ultrasound where the woman must be given an opportunity to view the image is required, parental notice is required before a woman can undergo the procedure, and require clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 8 / 10 Funding for Family Planning Clinics 4 / 10 25% of women in Florida live in a county without an abortion provider. Florida spent $92 in the fiscal year 2010 on family planning services per woman in need.

24 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Georgia is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Georgia. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Georgia is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Georgia received a failing grade, in part, because: n Georgia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must receive counseling 24 hours before her abortion procedure, which must include information about fetal pain. Furthermore, parental notice is required before the woman may undergo the procedure, and requires clinicians who perform medication abortion procedures to be licensed physicians. n Georgia mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. n Georgia has no laws affirming a woman s right to emergency contraception in the emergency room. n Georgia has decided not to expand their Medicaid program under the Affordable Care Act. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Georgia, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

25 F Georgia 43.8 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 11.2 / 15 Georgia has a teen pregnancy rate of 78 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Georgia has achieved 75% of the objective. Unintended Pregnancy Rate 10.6 / 15 57% of Georgia s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Georgia has achieved 70.5% of the target rate. Sex Education 0 / 15 Georgia mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Access to Emergency Contraception 0 / 5 Georgia has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Georgia has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Georgia offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line. Funding for Family Planning Clinics 6 / 10 Georgia spent $142 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 6 / 10 Georgia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must receive counseling 24 hours before her abortion procedure, which must include information about fetal pain. Furthermore, parental notice is required before the woman may undergo the procedure, and requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 5 / 10 57% of women in Georgia live in a county without an abortion provider.

26 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Hawaii is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Hawaii received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Hawaii s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY(30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Hawaii received a C grade because: n Hawaii mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n Hawaii does not mandate sex education in public schools. n Hawaii is expanding their Medicaid program under the Affordable Care Act, but currently does not offer an expansion for family planning services to the Medicaid plan. n Hawaii requires clinicians who perform medication abortion procedures to be licensed physicians. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

27 C Hawaii 62.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 11.7 / 15 Sex Education 0 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 9 / 10 Hawaii has a teen pregnancy rate of 76 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Hawaii has achieved 78.3% of the objective. Unintended Pregnancy Rate 11.6 / 15 Hawaii does not mandate sex education in public schools. Access to Emergency Contraception 5 / 5 Hawaii mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Hawaii is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Hawaii currently does not offer an expansion for family planning services to the Medicaid plan. Hawaii requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 10 / 10 0% of women in Hawaii live in a county without an abortion provider. 54% of Hawaii s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Hawaii has achieved 77.3% of the target rate. Funding for Family Planning Clinics 5 / 10 Hawaii spent $124 in the fiscal year 2010 on family planning services per woman in need.

28 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Idaho is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Idaho. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Idaho is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Idaho received a failing grade, in part, because: n Idaho has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required and requires clinicians who perform medication abortion procedures to be licensed physicians. Furthermore, there is limited insurance coverage for abortions. n Idaho does not mandate sex education in public schools. n Idaho has no laws affirming a woman s right to emergency contraception in the emergency room. n Idaho has decided not to expand their Medicaid program under the Affordable Care Act, and they do not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Idaho, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

29 F Idaho 43.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 6 / 10 Idaho has a teen pregnancy rate of 57 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Idaho has surpassed this objective. Unintended Pregnancy Rate 15 / 15 40% of Idaho s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Idaho has exceeded the target rate. Idaho does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Idaho has no laws affirming a woman s right to emergency contraception in the emergency room. Idaho has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Idaho currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 3 / 10 Idaho spent $69 in the fiscal year 2010 on family planning services per woman in need. Idaho has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required and requires clinicians who perform medication abortion procedures to be licensed physicians. Furthermore, there is limited insurance coverage for abortions. Abortion Access 4 / 10 69% of women in Idaho live in a county without an abortion provider.

30 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B Illinois is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Illinois received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Illinois s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Illinois received a B grade because: n Illinois requires parental notice before a woman may get an abortion. n Illinois mandates that emergency rooms provide information about emergency contraception, but does not require that they dispense it. n Illinois is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, as well as people who have lost coverage. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

31 B Illinois 69.7 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 13.7 / 15 Sex Education 7.5 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 9 / 10 Illinois has a teen pregnancy rate of 68 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Illinois has achieved 91.7% of the objective. Unintended Pregnancy Rate 11.9 / 15 53% of Illinois s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Illinois has achieved 79.5% of the target rate. Illinois requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 2.5 / 5 Illinois mandates that emergency rooms provide information about emergency contraception. Illinois is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Illinois offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, as well as people who have lost coverage. Funding for Family Planning Clinics 3 / 10 Illinois requires parental notice before a woman may undergo the procedure. Abortion Access 7 / 10 37% of women in Illinois live in a county without an abortion provider. Illinois spent $74 in the fiscal year 2010 on family planning services per woman in need.

32 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F- Indiana is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Indiana. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Indiana is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Indiana received a failing grade, in part, because: n Indiana has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on fetal pain, an ultrasound is required and the woman must be given an opportunity to view the image, there is a mandatory waiting period of 18 hours between abortion counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. n Indiana mandates HIV education, but it does not require that condoms be part of the curriculum. n Indiana has no laws affirming a woman s right to emergency contraception in the emergency room. n Indiana has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. Indiana received a minus because of a measure that was signed into law this year that prohibits the use of telemedicine to administer medication abortion; it requires that women get an ultrasound before getting a medication abortion; and requires that medication abortion providers meet the same building code and licensing standards as the ones required for surgical abortion facilities. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Indiana, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

33 F- Indiana 38.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansions 0 / 10 Abortion Restrictions 3 / 10 Indiana has a teen pregnancy rate of 59 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Indiana has surpassed this objective. Unintended Pregnancy Rate 13.6 / 15 48% of Indiana s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Indiana has achieved 90.9% of the target rate. Indiana mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 0 / 10 Indiana has no laws affirming a woman s right to emergency contraception in the emergency room. Indiana has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Indiana currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 3 / 10 Indiana has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on fetal pain, an ultrasound is required and the woman must be given an opportunity to view the image, there is a mandatory waiting period of 18 hours between abortion counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. Indiana spent $53 in the fiscal year 2010 on family planning services per woman in need. Abortion Access 4 / 10 66% of women in Indiana live in a county without an abortion provider.

34 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B- Iowa is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Iowa received a B-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Iowa s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Iowa received a B grade because: n It has a low teen pregnancy rate and a low unintended pregnancy rate. n Iowa is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 300% of the federal poverty line, as well as people who have lost coverage postpartum. Men and women under 19 are also covered. n Iowa mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Iowa received a minus because the Board of Medicine in August approved a regulation prohibiting using telemedicine for medication abortions. This means that women will have to travel to the clinic for each of the two doses. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

35 B- Iowa 65.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Iowa has a teen pregnancy rate of 51 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Iowa has surpassed this objective. Unintended Pregnancy Rate 15 / 15 44% of Iowa s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Iowa has achieved 100% of the target rate. Sex Education 0 / 15 Iowa mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Access to Emergency Contraception 0 / 5 Iowa has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Iowa is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Iowa offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 300% of the federal poverty line, as well as people who have lost coverage postpartum. Men and women under 19 are also covered. Abortion Restrictions 8 / 10 Iowa has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: requires parental notice and requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 5 / 10 51% of women in Iowa live in a county without an abortion provider. Funding for Family Planning Clinics 5 / 10 Iowa spent $109 in the fiscal year 2010 on family planning services per woman in need.

36 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F- Kansas is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Kansas. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Kansas is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY(30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Kansas received a failing grade, in part, because: n Kansas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on a breast cancer link, negative psychological effects, fetal pain, and an ultrasound, there is a mandatory waiting period of 24 hours between counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians, and there is limited insurance coverage for the procedure. n Kansas does not mandate sex education in public schools. n Kansas has decided not to expand their Medicaid program under the Affordable Care Act, and currently does not offer an expansion for family planning services to the Medicaid plan. Kansas received a minus because of a new law that protects medical professionals who withhold information about a women s pregnancy from her if that information might have resulted in her getting an abortion from litigation. Kansas also passed a law that sets up a priority based system for dispensing family planning funds. Facilities that are run by health agencies get the highest priority; any remaining funds can be applied for by private hospitals and federally qualified health centers. The new law says that other types of family planning providers would not be eligible for funding. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Kansas, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

37 F- Kansas 37.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Kansas has a teen pregnancy rate of 63 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Kansas has met this objective. Unintended Pregnancy Rate 14 / 15 47% of Kansas s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Kansas has achieved 93.2% of the target rate. Sex Education 0 / 15 Kansas does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Kansas has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Kansas has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Kansas currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 3 / 10 Kansas spent $60 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 0 / 10 Kansas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on a breast cancer link, negative psychological effects, fetal pain, and an ultrasound, there is a mandatory waiting period of 24 hours between counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians, and there is limited insurance coverage for the procedure. Abortion Access 5 / 10 57% of women in Kansas live in a county without an abortion provider.

38 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- Kentucky D- is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Kentucky received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Kentucky s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Kentucky received a D grade because: n Kentucky has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between abortion counseling and the procedure, parental consent is required, requires clinicians who perform medication abortion procedures to be licensed physicians, and there is limited insurance coverage. n 77% of women in Kentucky live in a county without an abortion provider. n Kentucky is expanding their Medicaid program under the Affordable Care Act, but currently does not offer an expansion for family planning services to the Medicaid plan. n Kentucky mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Kentucky received a minus because the Senate passed a bill that would require a woman seeking an abortion to get an ultrasound before she could get an abortion. The bill also requires the provider to show the woman the ultrasound image and describe the image to her. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

39 D- Kentucky 54.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 13 / 15 Sex Education 0 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 6 / 10 Kentucky has a teen pregnancy rate of 71 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Kentucky has achieved 86.6% of the objective. Unintended Pregnancy Rate 14.3/ 15 46% of Kentucky s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Kentucky has achieved 95.5% of the target rate. Kentucky mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Access to Emergency Contraception 0 / 5 Kentucky has no laws affirming a woman s right to emergency contraception in the emergency room. Kentucky is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Kentucky currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 8 / 10 Kentucky spent $196 in the fiscal year 2010 on family planning services per woman in need. Kentucky has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between abortion counseling and the procedure, parental consent is required, requires clinicians who perform medication abortion procedures to be licensed physicians, and there is limited insurance coverage. Abortion Access 3 / 10 77% of women in Kentucky live in a county without an abortion provider.

40 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F- Louisiana is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Louisiana. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Louisiana is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Louisiana received a failing grade, in part, because: n Louisiana has a high teen pregnancy rate of 80 pregnancies per 1,000 women aged 15-19, and a high unintended pregnancy rate where 62% of Louisiana s total pregnancies are unintended. n Louisiana has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on fetal pain and an ultrasound where the provider must display and describe the image, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians n Louisiana does not mandate sex education in public schools. n Louisiana has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line. Louisiana received a minus because they passed a law that would restrict women s access to abortion by prohibiting a physician from using telemedicine to prescribe a medication abortion. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Louisiana, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

41 F- Louisiana 37.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 10.7 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 3 / 10 Louisiana has a teen pregnancy rate of 80 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Louisiana has achieved 71.6% of the objective. Unintended Pregnancy Rate 8.9 / 15 62% of Louisiana s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Louisiana has achieved 59.1% of the target rate. Louisiana does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Louisiana has no laws affirming a woman s right to emergency contraception in the emergency room. Louisiana has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Louisiana offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line Funding for Family Planning Clinics 6 / 10 Louisiana spent $127 in the fiscal year 2010 on family planning services per woman in need. Louisiana has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks, the woman must undergo mandatory counseling including information on fetal pain and an ultrasound where the provider must display and describe the image, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required, and requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 4 / 10 65% of women in Louisiana live in a county without an abortion provider.

42 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Maine is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Maine received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Maine s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Maine received a C grade because: n Maine has a low teen pregnancy rate and low unintended pregnancy rate. n Maine mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Maine has no laws affirming a woman s right to emergency contraception in the emergency room. n Maine has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Maine, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

43 C Maine 62.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Maine has a teen pregnancy rate of 43 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Maine has surpassed the objective. Unintended Pregnancy Rate 14.3 / 15 46% of Maine s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Maine has achieved 95.5% of the target rate. Sex Education 15 / 15 Maine mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 Maine has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Maine has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Maine currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 4 / 10 Maine spent $98 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 9 / 10 Maine requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 5 / 10 51% of women in Maine live in a county without an abortion provider.

44 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- A Maryland or higher is one of 17 states receiving a B- WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Maryland received an A. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Maryland s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Maryland received a A grade because: n Maryland has a low teen pregnancy rate. n Maryland mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Maryland is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, as well as people who have lost coverage postpartum. Women under age 19 are also covered. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

45 A Maryland 80.9 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Maryland has a teen pregnancy rate of 63 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Maryland has achieved 100% of the objective. Unintended Pregnancy Rate 10.9 / 15 56% of Maryland s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Maryland has achieved 72.7% of the target rate. Sex Education 15 / 15 Maryland mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 Maryland has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Maryland is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Maryland offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, as well as people who have lost coverage postpartum. Women under age 19 are also covered. Funding for Family Planning Clinics 7 / 10 Maryland spent $172 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 8 / 10 Maryland requires clinicians who perform medication abortion procedures to be licensed physicians and parental notice is required. Abortion Access 8 / 10 20% of women in Maryland live in a county without an abortion provider.

46 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Massachusetts is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Massachusetts received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Massachusetts s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY(30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Massachusetts received a C grade because: n Massachusetts has a very low teen pregnancy rate. n Massachusetts mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n Massachusetts has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, parental consent is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. n Massachusetts does not mandate sex education in public schools. n Massachusetts is expanding their Medicaid program under the Affordable Care Act, but does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

47 C Massachusetts 64.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Massachusetts has a teen pregnancy rate of 42 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Massachusetts has surpassed the objective. Unintended Pregnancy Rate 13.6 / 15 48% of Massachusetts s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Massachusetts has achieved 90.9% of the target rate. Sex Education 0 / 15 Massachusetts does not mandate sex education in public schools. Access to Emergency Contraception 5 / 5 Massachusetts mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 Massachusetts is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Massachusetts currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 6 / 10 Massachusetts spent $145 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 6 / 10 Massachusetts has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, parental consent is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 9 / 10 10% of women in Massachusetts live in a county without an abortion provider.

48 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C Michigan is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Michigan received a C. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Michigan s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Michigan received a C grade because: n Michigan has a low teen pregnancy rate. n Michigan is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line. n Michigan has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on negative psychological effects, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. n Michigan mandates HIV education, but it does not require that condoms be part of the curriculum. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

49 C Michigan 58.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Michigan has a teen pregnancy rate of 58 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Michigan has surpassed the objective. Unintended Pregnancy Rate 11.6 / 15 54% of Michigan s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Michigan has achieved 77.3% of the target rate. Sex Education 0 / 15 Michigan mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 0 / 5 Michigan has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Michigan is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Michigan offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line. Funding for Family Planning Clinics 4 / 10 Michigan spent $87 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 6 / 10 Michigan has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on negative psychological effects, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, parental consent is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 7 / 10 32% of women in Michigan live in a county without an abortion provider.

50 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C- Minnesota is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Minnesota received a C-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Minnesota s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Minnesota received a C grade because: n Minnesota has a very low teen pregnancy rate. n Minnesota is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line. Men, as well as women under age 19, are also covered. n Minnesota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, the woman must undergo mandatory counseling including information on fetal pain after 20 weeks, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, notice of both parents is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. n Minnesota mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Minnesota received a minus because the House passed a measure that would require abortion providers be licensed as ambulatory surgical facilities if they perform at least 10 abortions a month. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

51 C- Minnesota 63.7 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Minnesota has a teen pregnancy rate of 42 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Minnesota has surpassed the objective. Unintended Pregnancy Rate 14.7 / 15 45% of Minnesota s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Minnesota has achieved 97.7% of the target rate. Sex Education 0 / 15 Minnesota mandates sex education in public schools, covering abstinence, HIV prevention, but does not require HIV education include condoms or sex education include contraception. Access to Emergency Contraception 5 / 5 Minnesota mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 Minnesota is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Minnesota offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line. Men, as well as women under age 19, are also covered. Funding for Family Planning Clinics 4 / 10 Minnesota spent $77 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 4 / 10 Minnesota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks, the woman must undergo mandatory counseling including information on fetal pain after 20 weeks, there is a mandatory waiting period of 24 hours between abortion counseling and procedure, notice of both parents is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 4 / 10 62% of women in Minnesota live in a county without an abortion provider.

52 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall F- receives a C- Mississippi is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Mississippi. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Mississippi is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Mississippi received a failing grade, in part, because: n Mississippi has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: women must undergo mandatory counseling including information on a breast cancer link, there is a mandatory waiting period of 24 hours between counseling and procedure with a mandatory ultrasound that the provider must offer the woman the opportunity to view, consent from both parents is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. n Mississippi has a high teen pregnancy rate of 90 pregnancies per 1,000 women aged and a high unintended pregnancy rate with 63% of Mississippi s total pregnancies being unintended. n Mississippi mandates sex education, but it does not require that contraception be part of the curriculum. n Mississippi has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line, as well as women under age 19, are also covered. Mississippi received a minus because of a law passed that prohibits the use of telemedicine to prescribe medication for abortion. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Mississippi, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

53 F- Mississippi 34.8 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 8.2 / 15 Mississippi has a teen pregnancy rate of 90 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Mississippi has achieved 54.9% of the objective. Unintended Pregnancy Rate 8.5 / 15 63% of Mississippi s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Mississippi has achieved 56.8% of the target rate. Sex Education 0 / 15 Mississippi mandates sex education, but it does not require that contraception be part of the curriculum. Access to Emergency Contraception 0 / 5 Mississippi has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Mississippi has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Mississippi offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line, as well as women under age 19, are also covered. Funding for Family Planning Clinics 5 / 10 Mississippi spent $118 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 5 / 10 Mississippi has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: women must undergo mandatory counseling including information on a breast cancer link, there is a mandatory waiting period of 24 hours between counseling and procedure with a mandatory ultrasound that the provider must offer the woman the opportunity to view, consent from both parents is required, and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 1 / 10 91% of women in Mississippi live in a county without an abortion provider.

54 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F- Missouri is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Missouri. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Missouri is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Missouri received a failing grade, in part, because: n Missouri has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on fetal pain; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; there is limited insurance coverage; and clinicians who perform medication abortion procedures are required to be licensed physicians. n 73% of women in Missouri live in a county without an abortion provider. n Missouri mandates HIV education, but it does not require that condoms be part of the curriculum. n Missouri has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver is offered to people with income levels up to 185% of the federal poverty line. Missouri received a minus because of a law passed that prohibits using telemedicine to remotely administer the initial dose of medication for abortion. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Missouri, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

55 F- Missouri 43.8 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 14.5 / 15 Missouri has a teen pregnancy rate of 65 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Missouri has achieved 96.7% of the objective. Unintended Pregnancy Rate 12.3 / 15 52% of Missouri s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Missouri has achieved 81.8% of the target rate. Sex Education 0 / 15 Missouri mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 0 / 5 Missouri has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Missouri has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Missouri offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver is offered to people with income levels up to 185% of the federal poverty line. Funding for Family Planning Clinics 5 / 10 Missouri spent $118 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 4 / 10 Missouri has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on fetal pain; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; there is limited insurance coverage; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 3 / 10 73% of women in Missouri live in a county without an abortion provider.

56 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- Montana D- is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Montana received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Montana s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Montana received a D grade because: n Montana mandates sex education and HIV education in public schools but does not require that condoms or contraceptives be included in the curriculum. n Montana has no laws affirming a woman s right to emergency contraception in the emergency room. n Montana has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line and loss of coverage postpartum. Montana received a minus because of a law passed that would protect medical professionals who withhold information from a woman about her pregnancy that may have resulted in her getting an abortion from litigation. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Montana, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

57 D- Montana 51.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Montana has a teen pregnancy rate of 59 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Montana has surpassed the objective. Unintended Pregnancy Rate 13 / 15 50% of Montana s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Montana has achieved 86.4% of the target rate. Sex Education 0 / 15 Montana mandates sex education and HIV education in public schools but does not require that condoms or contraceptives be included in the curriculum. Access to Emergency Contraception 0 / 5 Montana has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Montana has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Montana offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line and loss of coverage postpartum. Funding for Family Planning Clinics 3 / 10 Montana spent $74 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 9 / 10 Montana requires parental notice before a woman may undergo the procedure. Abortion Access 6 / 10 48% of women in Montana live in a county without an abortion provider.

58 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Nebraska is one of 13 states receiving an F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Nebraska. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Nebraska is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Nebraska received a failing grade, in part, because: n Nebraska has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. n Nebraska does not mandate sex education in public schools. n Nebraska has no laws affirming a woman s right to emergency contraception in the emergency room. n Nebraska has decided not to expand their Medicaid program under the Affordable Care Act and does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Nebraska, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

59 F Nebraska 41.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 3 / 10 Nebraska has a teen pregnancy rate of 50 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Nebraska has surpassed the objective. Unintended Pregnancy Rate 14.3 / 15 46% of Nebraska s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Nebraska has achieved 95.5% of the target rate. Nebraska does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Nebraska has no laws affirming a woman s right to emergency contraception in the emergency room. Nebraska has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Nebraska currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 3 / 10 Nebraska spent $67 in the fiscal year 2010 on family planning services per woman in need. Nebraska has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. Clinic Access Protection 6 / 10 43% of women in Nebraska live in a county without an abortion provider.

60 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D Nevada is one of 12 states receiving an D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Nevada received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Nevada s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Nevada received a D grade because: n Nevada has a high teen pregnancy rate of 84 pregnancies per 1,000 women aged n Nevada has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: prohibited abortion after 24 weeks and clinicians who perform medication abortion procedures are required to be licensed physicians. n Nevada does mandate sex education and HIV education in public schools, but it sets no requirement to teach about condoms and contraception. n Nevada has no laws affirming a woman s right to emergency contraception in the emergency room. n Nevada is expanding their Medicaid program under the Affordable Care Act, but does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

61 D Nevada 51.7 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 9.7 / 15 Nevada has a teen pregnancy rate of 84 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Nevada has achieved 64.9% of the objective. Unintended Pregnancy Rate 13 / 15 50% of Nevada s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Nevada has achieved 86.4% of the target rate. Sex Education 0 / 15 Nevada does mandate sex education and HIV education in public schools, but it sets no requirement to teach about condoms and contraception. Access to Emergency Contraception 0 / 5 Nevada has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Nevada is expanding their Medicaid program under the Affordable Care Act.. Medicaid Family Planning Expansions 0 / 10 Nevada currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 2 / 10 Nevada spent $41 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 7 / 10 Nevada has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: prohibited abortion after 24 weeks and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 10 / 10 8% of women in Nevada live in a county without an abortion provider.

62 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D New Hampshire is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. New Hampshire received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With New Hampshire s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. New Hampshire received a D grade because: n New Hampshire has a very low teen pregnancy rate and a low unintended pregnancy rate. n New Hampshire mandates HIV education, but it does not require that condoms be part of the curriculum. n New Hampshire has no laws affirming a woman s right to emergency contraception in the emergency room. n New Hampshire has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including New Hampshire, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

63 D New Hampshire 51.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 9 / 10 New Hampshire has a teen pregnancy rate of 33 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that New Hampshire has surpassed the objective. Unintended Pregnancy Rate 15 / 15 New Hampshire mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 0 / 5 New Hampshire has no laws affirming a woman s right to emergency contraception in the emergency room. New Hampshire has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 New Hampshire currently does not offer an expansion for family planning services to the Medicaid plan. New Hampshire requires parental notice before a woman may undergo the procedure. Abortion Access 9 / 10 19% of women in New Hampshire live in a county without an abortion provider. 40% of New Hampshire s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, New Hampshire has surpassed the target rate. Funding for Family Planning Clinics 3 / 10 New Hampshire spent $72 in the fiscal year 2010 on family planning services per woman in need.

64 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B New Jersey is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but New Jersey received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. New Jersey s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. New Jersey received a B grade because: n Only 9% of women in New Jersey live in a county without an abortion provider. n New Jersey mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n New Jersey mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n New Jersey is expanding their Medicaid program under the Affordable Care Act, but does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

65 B New Jersey 79.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 New Jersey has a teen pregnancy rate of 62 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that New Jersey has achieved the objective. Unintended Pregnancy Rate 11.6 / 15 54% of New Jersey s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, New Jersey has achieved 77.3% of the target rate. Sex Education 15 / 15 New Jersey mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 5 / 5 New Jersey mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 New Jersey is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 New Jersey currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 4 / 10 New Jersey spent $88 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 9 / 10 New Jersey requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 10 / 10 9% of women in New Jersey live in a county without an abortion provider.

66 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B New Mexico is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but New Mexico received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. New Mexico s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. New Mexico received a B grade because: n New Mexico is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 185% of the federal poverty line covers men and women under 19. n New Mexico mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n New Mexico mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

67 B New Mexico 78.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 7.5 / 15 New Mexico has a teen pregnancy rate of 93 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that New Mexico has achieved 49.9% of the objective. Unintended Pregnancy Rate 12.6 / 15 51% of New Mexico s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, New Mexico has achieved 84.1% of the target rate. Sex Education 15 / 15 New Mexico mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 5 / 5 New Mexico mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 New Mexico is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 New Mexico offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 185% of the federal poverty line covers men and women under 19. Funding for Family Planning Clinics 4/ 10 New Mexico spent $86 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 9 / 10 New Mexico requires clinicians who perform medication abortion procedures to be licensed physicians. Abortion Access 5 / 10 50% of women in New Mexico live in a county without an abortion provider.

68 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B New York is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but New York received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. New York s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. New York received a B grade because: : n Only 7% of women in New York live in a county without an abortion provider. n New York is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. n New York requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. n New York mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

69 B New York 77.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 13 / 15 Sex Education 7.5 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 8 / 10 New York has a teen pregnancy rate of 71 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that New York has achieved 86.6% of the objective. Unintended Pregnancy Rate 11.6 / 15 54% of New York s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, New York has achieved 77.3% of the target rate. New York requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 5 / 5 New York mandates that emergency rooms provide information about emergency contraception and dispense it upon request. New York is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 New York offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. New York has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: prohibits abortion after 24 weeks. Abortion Access 10 / 10 7% of women in New York live in a county without an abortion provider. Funding for Family Planning Clinics 5 / 10 New York spent $107 in the fiscal year 2010 on family planning services per woman in need.

70 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B- North Carolina is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but North Carolina received a B-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. North Carolina s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. North Carolina received a B grade because: n North Carolina mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n North Carolina has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment is offered to people with income levels up to 185% of the federal poverty line including men and women under 19. n North Carolina has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. North Carolina received a minus because of a new abortion law that among other things requires abortion clinics to meet the same standards as ambulatory surgical centers and prohibits using telemedicine to prescribe medication for abortion. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including North Carolina, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

71 B- North Carolina 65.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 12.7 / 15 North Carolina has a teen pregnancy rate of 72 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that North Carolina has achieved 85% of the objective. Unintended Pregnancy Rate 12.3 / 15 52% of North Carolina s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, North Carolina has achieved 81.8% of the target rate. Sex Education 15 / 15 North Carolina mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 North Carolina has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 North Carolina has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 North Carolina offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment is offered to people with income levels up to 185% of the federal poverty line including men and women under 19. Funding for Family Planning Clinics 6 / 10 North Carolina spent $128 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 4 / 10 North Carolina has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 5 / 10 50% of women in North Carolina live in a county without an abortion provider.

72 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D- North Dakota is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. North Dakota received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With North Dakota s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. North Dakota received a D grade because: n North Dakota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; there is a mandatory waiting period of 24 hours between counseling and procedure; requires that the woman be provided with the opportunity to view an ultrasound image; parental consent from both parents is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. n 74% of women in North Dakota live in a county without an abortion provider. n New Dakota is expanding their Medicaid program under the Affordable Care Act, but currently does not offer an expansion for family planning services to the Medicaid plan. North Dakota received a minus because of a law passed that would ban abortion once the fetal heartbeat is detected, which is about six weeks after the woman s last menstrual period. However a federal judge has blocked this law ruling it unconstitutional. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

73 D- North Dakota 46.6 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 3 / 10 North Dakota has a teen pregnancy rate of 42 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that North Dakota has surpassed the objective. Unintended Pregnancy Rate 13.6 / 15 48% of North Dakota s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, North Dakota has achieved 90.9% of the target rate. North Dakota mandates sex education in public schools but requires abstinence-only sex education, a form that research has considered ineffective. Access to Emergency Contraception 0 / 5 North Dakota has no laws affirming a woman s right to emergency contraception in the emergency room. New Dakota is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 North Dakota currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 2 / 10 North Dakota spent $50 in the fiscal year 2010 on family planning services per woman in need. North Dakota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; there is a mandatory waiting period of 24 hours between counseling and procedure; requires that the woman be provided with the opportunity to view an ultrasound image; parental consent from both parents is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. Abortion Access 3 / 10 74% of women in North Dakota live in a county without an abortion provider.

74 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B- Ohio is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Ohio received a B-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Ohio s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Ohio received a B grade because: n Ohio has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n Ohio is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 200% of the federal poverty line, men, and women under age 19. n Ohio mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Ohio received a minus because included in the state budget was a provision that prohibits public hospitals from entering into transfer agreements with abortion providers. There is existing law that requires abortion clinics to have an agreement with a hospital that would allow for the transfer of a patient in the event of an emergency. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

75 B- Ohio 66.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 7 / 10 Ohio has a teen pregnancy rate of 62 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Ohio has achieved the objective. Unintended Pregnancy Rate 11.3 / 15 55% of Ohio s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Ohio has achieved 75% of the target rate. Ohio does mandate sex education in public schools but requires abstinence-only sex education, a form that research has considered ineffective. Access to Emergency Contraception 5 / 5 Ohio mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Ohio is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 Ohio offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 200% of the federal poverty line, men, and women under age 19 Ohio has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 5 / 10 55% of women in Ohio live in a county without an abortion provider. Funding for Family Planning Clinics 3 / 10 Ohio spent $59 in the fiscal year 2010 on family planning services per woman in need.

76 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D- Oklahoma is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Oklahoma received a D-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Oklahoma s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Oklahoma received a D grade because: n Oklahoma has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on a breast cancer link, fetal pain; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. n Oklahoma has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 250% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. n Oklahoma has no laws affirming a woman s right to emergency contraception in the emergency room. Oklahoma received a minus because of a law passed that will make it more difficult for minors to obtain an abortion. The new law requires that a parent provide a government issued identification and prove parental status with written documentation. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Oklahoma, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

77 D- Oklahoma 54.5 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 10.7 / 15 Sex Education 7.5 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 4 / 10 Oklahoma has a teen pregnancy rate of 80 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Oklahoma has achieved 71.6% of the objective. Unintended Pregnancy Rate 13.3 / 15 55% of Oklahoma s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Oklahoma has achieved 75% of the target rate. Oklahoma requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 0 / 5 Oklahoma has no laws affirming a woman s right to emergency contraception in the emergency room. Oklahoma has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 Oklahoma offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 250% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. Funding for Family Planning Clinics 6 / 10 Oklahoma has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on a breast cancer link, fetal pain; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; clinicians who perform medication abortion procedures are required to be licensed physicians; and there is limited insurance coverage. Abortion Access 5 / 10 56% of women in Oklahoma live in a county without an abortion provider. Oklahoma spent $128 in the fiscal year 2010 on family planning services per woman in need.

78 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- A Oregon is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Oregon received an A. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Oregon s grade suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Oregon received an A grade because: n Oregon has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. n Oregon mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Oregon mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n Oregon is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 250% of the federal poverty line, men, and women under age 19. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

79 A Oregon 90.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Oregon has a teen pregnancy rate of 60 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Oregon has surpassed the objective. Unintended Pregnancy Rate 13 / 15 50% of Oregon s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Oregon has achieved 86.4% of the target rate. Sex Education 15 / 15 Oregon mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 5 / 5 Oregon mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 10 / 10 Oregon is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Oregon offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 250% of the federal poverty line, men, and women under age 19. Funding for Family Planning Clinics 7 / 10 Oregon spent $164 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 10 / 10 Oregon has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 8 / 10 23% of women in Oregon live in a county without an abortion provider.

80 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D Pennsylvania is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Pennsylvania received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Pennsylvania s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Pennsylvania received a D grade because: n Pennsylvania has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n Pennsylvania mandates HIV education, but it does not require that condoms be part of the curriculum. n Pennsylvania has no laws affirming a woman s right to emergency contraception in the emergency room. n Pennsylvania has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver is offered to people with income levels up to 185% of the federal poverty line. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Pennsylvania, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

81 D Pennsylvania 48.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 5 / 10 Pennsylvania has a teen pregnancy rate of 56 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Pennsylvania has surpassed the objective. Unintended Pregnancy Rate 12.3 / 15 52% of Pennsylvania s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Pennsylvania has achieved 81.8% of the target rate. Pennsylvania mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 0 / 5 Pennsylvania has no laws affirming a woman s right to emergency contraception in the emergency room. Pennsylvania has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Pennsylvania offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver is offered to people with income levels up to 185% of the federal poverty line. Funding for Family Planning Clinics 5 / 10 Pennsylvania has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 6 / 10 46% of women in Pennsylvania live in a county without an abortion provider. Pennsylvania spent $122 in the fiscal year 2010 on family planning services per woman in need.

82 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B Rhode Island is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Rhode Island received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Rhode Island s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Rhode Island received a B grade because: n Rhode Island has a low teen pregnancy rate. n Rhode Island mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Rhode Island is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to those with loss of coverage 2 years postpartum, but does not expand based on income. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

83 B Rhode Island 68.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Rhode Island has a teen pregnancy rate of 53 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Rhode Island has surpassed the objective. Unintended Pregnancy Rate 11.3 / 15 55% of Rhode Island s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Rhode Island has achieved 75% of the target rate. Sex Education 15 / 15 Rhode Island mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 Rhode Island has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 Rhode Island is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Rhode Island offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to those with loss of coverage 2 years postpartum, but does not expand based on income. Funding for Family Planning Clinics 3 / 10 Rhode Island spent $57 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 7 / 10 Rhode Island has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks and parental consent is required. Abortion Access 7 / 10 38% of women in Rhode Island live in a county without an abortion provider.

84 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B South Carolina is one of 17 states receiving a B- or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but South Carolina received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. South Carolina s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. South Carolina received a B grade because: n South Carolina has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n South Carolina mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n South Carolina has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 185% of the federal poverty line, men, and women under age 19. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including South Carolina, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

85 B South Carolina 65.2 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 11.7 / 15 Sex Education 15 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 7 / 10 South Carolina has a teen pregnancy rate of 76 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that South Carolina has achieved 78.3% of the objective. Unintended Pregnancy Rate 10.9 / 15 56% of South Carolina s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, South Carolina has achieved 72.7% of the target rate. South Carolina mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 2.5 / 5 South Carolina mandates that emergency rooms dispense emergency contraception upon request. South Carolina has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 South Carolina offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 185% of the federal poverty line, men, and women under age 19. Funding for Family Planning Clinics 5 / 10 South Carolina has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 3 / 10 73% of women in South Carolina live in a county without an abortion provider. South Carolina spent $110 in the fiscal year 2010 on family planning services per woman in need.

86 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall F- receives a C- South Dakota is one of 13 states receiving an F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including South Dakota. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that South Dakota is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. South Dakota received a failing grade, in part, because: n South Dakota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks; the woman must undergo mandatory counseling including information on fetal pain and negative psychological effects; there is a mandatory waiting period of 72 hours between counseling and procedure; requires that the woman be provided with the opportunity to view an ultrasound image; parental notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n 76% of women in South Dakota live in a county without an abortion provider. n South Dakota does not mandate sex education in public schools. n South Dakota has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. South Dakota received a minus because it passed a law clarifying that the 72 hour waiting period before a woman can obtain an abortion does not include weekends or any annually recurring holiday. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including South Dakota, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

87 F- South Dakota 37.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 2 / 10 South Dakota has a teen pregnancy rate of 53 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that South Dakota has surpassed the objective. Unintended Pregnancy Rate 14 / 15 47% of South Dakota s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, South Dakota has achieved 93.2% of the target rate. South Dakota does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 South Dakota has no laws affirming a woman s right to emergency contraception in the emergency room. South Dakota has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 South Dakota currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 3 / 10 South Dakota has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 24 weeks; the woman must undergo mandatory counseling including information on fetal pain and negative psychological effects; there is a mandatory waiting period of 72 hours between counseling and procedure; requires that the woman be provided with the opportunity to view an ultrasound image; parental notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. South Dakota spent $64 in the fiscal year 2010 on family planning services per woman in need. Abortion Access 3 / 10 76% of women in South Dakota live in a county without an abortion provider.

88 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Tennessee is one of 13 states receiving an F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Tennessee. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Tennessee is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Tennessee received a failing grade, in part, because: n Tennessee does mandate sex education in public schools, but it requires abstinence-only sex education, a form that research has considered ineffective. n Tennessee has no laws affirming a woman s right to emergency contraception in the emergency room. n Tennessee has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Tennessee, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

89 F Tennessee 41.7 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 11.7 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 8 / 10 Tennessee has a teen pregnancy rate of 76 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Tennessee has achieved 78.3% of the objective. Unintended Pregnancy Rate 10.9 / 15 56% of Tennessee s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Tennessee has achieved 72.7% of the target rate. Tennessee does mandate sex education in public schools, but it requires abstinenceonly sex education, a form that research has considered ineffective. Access to Emergency Contraception 0 / 5 Tennessee has no laws affirming a woman s right to emergency contraception in the emergency room. Tennessee has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Tennessee currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 6 / 10 Tennessee spent $135 in the fiscal year 2010 on family planning services per woman in need. Tennessee has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: parental consent is required and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 5 / 10 59% of women in Tennessee live in a county without an abortion provider.

90 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F- Texas is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Texas. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Texas is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Texas received a failing grade, in part, because: n Texas has a high teen pregnancy rate of 85 pregnancies per 1,000 women aged n Texas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on a breast cancer link, fetal pain, negative psychological effects, and get an ultrasound where the provider is required to show and describe the image; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n Texas does not mandate sex education in public schools. n Texas has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line. Texas received a minus because of an abortion law that among other things would require that abortion clinics meet the same standards as ambulatory surgical centers. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Texas, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

91 F- Texas 41.3 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 9.5 / 15 Texas has a teen pregnancy rate of 85 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Texas has achieved 63.3% of the objective. Unintended Pregnancy Rate 12.3 / 15 52% of Texas s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Texas has achieved 81.8% of the target rate. Sex Education 0 / 15 Texas does not mandate sex education in public schools. Access to Emergency Contraception 2.5 / 5 Texas mandates that emergency rooms provide information about emergency contraception. Medicaid Expansion 0 / 10 Texas has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 5 / 10 Texas offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 185% of the federal poverty line. Abortion Restrictions 1 / 10 Texas has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: abortion is prohibited after 20 weeks; the woman must undergo mandatory counseling including information on a breast cancer link, fetal pain, negative psychological effects, and get an ultrasound where the provider is required to show and describe the image; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Funding for Family Planning Clinics 4 / 10 Texas spent $88 in the fiscal year 2010 on family planning services per woman in need. Abortion Access 7 / 10 33% of women in Texas live in a county without an abortion provider.

92 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Utah is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Utah. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Utah is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Utah received a failing grade, in part, because: n Utah has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on fetal pain at 20 weeks, negative psychological effects; there is a mandatory waiting period of 72 hours between counseling and procedure with a mandatory ultrasound that the provider must offer the woman the opportunity to view the image; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. There is also limited insurance coverage. n Utah does mandate sex education and HIV education in public schools, but it requires abstinence-only sex education, a form that research has considered ineffective. n Utah has decided not to expand their Medicaid program under the Affordable Care Act, and does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Utah, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

93 F Utah 44.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 3 / 10 Utah has a teen pregnancy rate of 48 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Utah has surpassed the objective. Unintended Pregnancy Rate 15 / 15 37% of Utah s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Utah has surpassed the target rate. Utah does mandate sex education and HIV education in public schools, but it requires abstinence-only sex education, a form that research has considered ineffective. Access to Emergency Contraception 5 / 5 Utah mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Utah has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Utah currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 2 / 10 Utah spent $31 in the fiscal year 2010 on family planning services per woman in need. Utah has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on fetal pain at 20 weeks, negative psychological effects; there is a mandatory waiting period of 72 hours between counseling and procedure with a mandatory ultrasound that the provider must offer the woman the opportunity to view the image; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. There is also limited insurance coverage. Abortion Access 4 / 10 64% of women in Utah live in a county without an abortion provider.

94 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B Vermont is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Vermont received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Vermont s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Vermont received a B grade because: n Vermont has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. n Vermont has a very low teen pregnancy rate. n Vermont mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n Vermont is expanding their Medicaid program under the Affordable Care Act, but does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

95 B Vermont 78.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 15 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 10 / 10 Vermont has a teen pregnancy rate of 38 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Vermont has surpassed the objective. Unintended Pregnancy Rate 14 / 15 47% of Vermont s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Vermont has achieved 93.2% of the target rate. Vermont mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 Vermont has no laws affirming a woman s right to emergency contraception in the emergency room. Vermont is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Vermont currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 6 / 10 Vermont spent $146 in the fiscal year 2010 on family planning services per woman in need. Vermont has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 8 / 10 24% of women in Vermont live in a county without an abortion provider.

96 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- D Virginia is one of 12 states receiving a D WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Virginia received a D. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Virginia s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Virginia received a D grade because: n Virginia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo an ultrasound where the provider must offer the woman the opportunity to view the image; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n Virginia does not mandate sex education in public schools. n Virginia has no laws affirming a woman s right to emergency contraception in the emergency room. n Virginia has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 200% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Virginia, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

97 D Virginia 51.9 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Virginia has a teen pregnancy rate of 56 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Virginia has surpassed the objective.. Unintended Pregnancy Rate 11.9/ 15 53% of Virginia s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Virginia has achieved 79.5% the target rate. Sex Education 0 / 15 Virginia does not mandate sex education in public schools.. Access to Emergency Contraception 0 / 5 Virginia has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 0 / 10 Virginia has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 Virginia offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 200% of the federal poverty line, loss of coverage postpartum, men, and women under age 19. Funding for Family Planning Clinics 4 / 10 Virginia spent $77 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 6 / 10 Virginia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo an ultrasound where the provider must offer the woman the opportunity to view the image; there is a mandatory waiting period of 24 hours between counseling and procedure; parental consent and notice is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 5 / 10 54% of women in Virginia live in a county without an abortion provider.

98 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- A+ Washington is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but Washington received an A+. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. Washington s grade suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Washington received an A grade because: n Washington has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. n Washington requires HIV education with information on condoms in its sex education curriculum, but not sex education with other methods of contraception. n Washington mandates that emergency rooms provide information about emergency contraception and dispense it upon request. n Washington is expanding their Medicaid program under the Affordable Care Act, and offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, men, and women under age 19. Washington received a plus because the Washington House approved a bill that would require health plans to cover abortion care if they cover maternity care, unless the purchaser opts out of the coverage. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

99 A+ Washington 84.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Sex Education 7.5 / 15 Medicaid Expansion 10 / 10 Abortion Restrictions 10 / 10 Washington has a teen pregnancy rate of 60 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Washington has surpassed the objective. Unintended Pregnancy Rate 13.6 / 15 48% of Washington s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Washington has achieved 90.9% of the target rate. Washington requires HIV education with information on condoms in its sex education curriculum, but not other methods of contraception. Access to Emergency Contraception 5 / 5 Washington mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Washington is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 7 / 10 Washington offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with income levels up to 200% of the federal poverty line, men, and women under age 19. Washington has no laws that make it unnecessarily difficult for a woman to have an abortion if she chooses to do so. Abortion Access 9 / 10 11% of women in Washington live in a county without an abortion provider. Funding for Family Planning Clinics 7 / 10 Washington spent $168 in the fiscal year 2010 on family planning services per woman in need.

100 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- B West Virginia is one of 17 states receiving a B or higher WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-, but West Virginia received a B. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. West Virginia s grade, while not an A+, suggests that it is doing a better job than most states in meeting the reproductive health needs of women in their state. This is critical because failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. West Virginia received a B grade because: n West Virginia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; and parental notice is required. n West Virginia mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. n West Virginia is expanding their Medicaid program under the Affordable Care Act, but currently does not offer an expansion for family planning services to the Medicaid plan. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

101 B West Virginia 66.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 14.5 / 15 West Virginia has a teen pregnancy rate of 65 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that West Virginia has achieved 96.7% of the objective. Unintended Pregnancy Rate 12.6 / 15 51% of West Virginia s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, West Virginia has achieved 84.1% of the target rate. Sex Education 15 / 15 West Virginia mandates comprehensive sex education in public schools, covering abstinence, HIV prevention, as well as different methods of contraception. Access to Emergency Contraception 0 / 5 West Virginia has no laws affirming a woman s right to emergency contraception in the emergency room. Medicaid Expansion 10 / 10 West Virginia is expanding their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 West Virginia currently does not offer an expansion for family planning services to the Medicaid plan. Funding for Family Planning Clinics 5 / 10 West Virginia spent $105 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 7 / 10 West Virginia has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: the woman must undergo mandatory counseling including information on negative psychological effects; there is a mandatory waiting period of 24 hours between counseling and procedure; and parental notice is required. Abortion Access 2 / 10 84% of women in West Virginia live in a county without an abortion provider.

102 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- C- Wisconsin is one of 9 states receiving a C WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Wisconsin received a C-. Thirteen states receive a failing grade. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With Wisconsin s poor grade it is clear they are not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus reflecting factors, such as pending legislation, not accounted for in the core grade. Wisconsin received a C grade because: n Wisconsin has a low teen pregnancy and low unintended pregnancy rate. n Wisconsin has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; a women is required get an ultrasound where the provider is must show and describe the image; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. n Wisconsin mandates HIV education, but it does not require that condoms be part of the curriculum. n Wisconsin has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 300% of the federal poverty line, men, and women under age 19. Wisconsin received a minus because the Wisconsin Assembly passed a measure that would allow religious non-profits to refuse to provide health coverage for contraceptives on the basis of religious beliefs. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Wisconsin, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

103 C- Wisconsin 61.0 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 15 / 15 Wisconsin has a teen pregnancy rate of 45 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Wisconsin has surpassed the objective. Unintended Pregnancy Rate 15 / 15 40% of Wisconsin s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Wisconsin has surpassed the target rate. Sex Education 0 / 15 Wisconsin mandates HIV education, but it does not require that condoms be part of the curriculum. Access to Emergency Contraception 5 / 5 Wisconsin mandates that emergency rooms provide information about emergency contraception and dispense it upon request. Medicaid Expansion 0 / 10 Wisconsin has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 10 / 10 Wisconsin offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of an amendment, is offered to people with income levels up to 300% of the federal poverty line, men, and women under age 19. Funding for Family Planning Clinics 6 / 10 Wisconsin spent $142 in the fiscal year 2010 on family planning services per woman in need. Abortion Restrictions 6 / 10 Wisconsin has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so: there is a mandatory waiting period of 24 hours between counseling and procedure; a women is required get an ultrasound where the provider is must show and describe the image; parental consent is required; and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 4 / 10 63% of women in Wisconsin live in a county without an abortion provider.

104 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- F Wyoming is one of 13 states receiving a F WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, including Wyoming. The U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, Every woman should be able to access affordable reproductive health care and young people should be getting comprehensive sex education in their school no matter where they live. With a failing grade it is clear that Wyoming is not meeting the reproductive health needs of women in the state. Failing to meet these needs can contribute to high rates of unintended pregnancies, including teen pregnancies. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia on four broad indicators relating to reproductive health and rights: EFFECTIVENESS (30 points): Statewide, what percentage of pregnancies is unintended, and how high is the state s teenage pregnancy rate? PREVENTION (20 points): Does the state promote comprehensive sex education in the schools, and does it support access to emergency contraception? AFFORDABILITY (30 points): Does the state have policies designed to make birth control affordable to uninsured and low-income individuals? ACCESS (20 points): Does the state impose harassing or burdensome requirements on those seeking family planning or abortion services? Based upon their composite scores (0-100), each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Wyoming received a failing grade, in part, because: n 96% of women in Wyoming live in a county without an abortion provider. n Wyoming does not mandate sex education in public schools. n Wyoming has no laws affirming a woman s right to emergency contraception in the emergency room. n Wyoming has decided not to expand their Medicaid program under the Affordable Care Act, but offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with loss of coverage postpartum, but does not expand coverage based on income. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). Other states receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, and Utah. Walker said, This year should have brought increased access to reproductive health care for women under the Affordable Care Act. Unfortunately 25 states, including Wyoming, have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know how their state ranks vis-à-vis other states. Despite the continued decline of the teenage pregnancy rate, America s teenage pregnancy rate is still higher than any other industrialized nation; nearly 3 out of 10 teenage girls will become pregnant. Nearly half of all pregnancies in the U.S. are unintended. To change this we must ensure that women, including young women, have access to affordable reproductive health services and young people get a comprehensive sex education. For the complete report card and additional information, please visit:

105 F Wyoming 40.1 / 100 Breakdown of Scores EFFECTIVENESS PREVENTION AFFORDABILITY ACCESS Teen Pregnancy Rate 13.7 / 15 Sex Education 0 / 15 Medicaid Expansion 0 / 10 Abortion Restrictions 8 / 10 Wyoming has a teen pregnancy rate of 68 pregnancies per 1,000 women aged Healthy People 2020 set 63 births per 1,000 teen women as the goal, which indicates that Wyoming has achieved 91.7% of the objective. Unintended Pregnancy Rate 14.3 / 15 46% of Wyoming s total pregnancies are unintended, compared to the Healthy People 2020 objective of 44%. Thus, Wyoming has achieved 95.5% the target rate. Wyoming does not mandate sex education in public schools. Access to Emergency Contraception 0 / 5 Wyoming has no laws affirming a woman s right to emergency contraception in the emergency room. Wyoming has decided not to expand their Medicaid program under the Affordable Care Act. Medicaid Family Planning Expansions 0 / 10 Wyoming offers Medicaid expansions to cover family planning services for people who otherwise do not qualify for Medicaid. The expansion, in the form of a waiver, is offered to people with loss of coverage postpartum, but does not expand coverage based on income. Wyoming has the following laws, which make it unnecessarily difficult for a woman to have an abortion if she chooses to do so parental consent and notice is required and clinicians who perform medication abortion procedures are required to be licensed physicians. Abortion Access 1 / 10 96% of women in Wyoming live in a county without an abortion provider. Funding for Family Planning Clinics 3 / 10 Wyoming spent $73 in the fiscal year 2010 on family planning services per woman in need.

106 The Population Institute Releases its 2013 Report Card on Reproductive Health and Rights U.S. overall receives a C- for second year in a row Only 17 states receive a B- or higher; 13 states receive a failing grade. WASHINGTON, D.C. The Population Institute today released its second annual report card on reproductive health and rights in the U.S., and the results were not encouraging. Thirteen states receive a failing grade, and the U.S. as a whole received a C-. In releasing the report card, Robert Walker, the organization s President, said, This year we have seen a lot of victories at the national level, but with states limiting the full scope of that progress. The major victories include: HHS ruling that Plan B One Step be made available over the counter without an age restriction, the Affordable Care Act giving women access to family planning services without a co-pay requirement, and expanded Medicaid eligibility ensuring that millions more women would be eligible to access reproductive health services. Unfortunately, at the state level, attacks on reproductive health care have continued unabated and twenty five states have refused to expand their Medicaid program denying millions of women access to health care. While Congress has rejected efforts by social conservatives to de-fund family planning programs, several states are drastically reducing their funding for family planning and restricting funding to Planned Parenthood and other providers of contraceptive services. Walker warned that, While opposition to abortion is driving these political assaults, putting family planning clinics out of business will only increase the number of unwanted pregnancies and, as a consequence, the number of abortions being performed. Using nine criteria, the Institute s report card ranked each of the 50 states and the District of Columbia: n Thirty percent of the grade is based on measures of effectiveness. This includes the latest available data on the teenage pregnancy rate (15%) and the rate of unintended pregnancies (15%). n Twenty percent of the grade is based upon prevention. This includes mandated comprehensive sex education in the schools (15%) and access to emergency contraception (5%). n Thirty percent of the grade is based upon affordability. This includes if states are expanding Medicaid under the Affordable Care Act (10%), Medicaid eligibility rules for family planning (10%), and funding for family planning clinics serving low-income families (10%). n The final twenty percent of the grade is based upon clinic access. This includes abortion restrictions (10%) and percent of women living in a county without an abortion provider (10%). Based upon their scores, each state received a core grade (A, B, C, D or F), but some states received an additional plus or a minus for factors not reflected in the core grade, such as pending changes or legislation. Only seventeen states received a B- or higher. Just four states (California, Maryland, Oregon and Washington) received an A. Oregon received the highest composite score. Thirteen states received a failing grade ( F ). States receiving a failing grade included Georgia, Idaho, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, South Dakota, Tennessee, Texas, Utah, and Wyoming. Walker said, The Affordable Care Act this year should have produced a nationwide improvement in access to reproductive health care services, but 25 states have refused to expand their Medicaid coverage leaving millions without increased access to services. It is imperative that people who care about reproductive health and rights know what states are doing in terms of expanded Medicaid eligibility. In issuing the report, Walker warned that the status of reproductive health and rights in many states is under continuing assault. According to the Guttmacher Institute states have enacted 106 provisions relating to reproductive health including abortion, family planning funding, and sex education in just the first six months of While the assault on women s reproductive health may be losing some momentum at the state level, Walker warned that, Reproductive health advocates must remain ever vigilant. For a copy of the report, including a state-by-state breakdown, visit the Population Institute s website For questions about the report, call Jennie Wetter, Director of Public Policy, at (202) , ext. 108.

107 FINAL GRADE OVERVIEW GRADES A+ to A B to B- C to C- D to D- F to F- STATE BREAKDOWNS: For state press releases and state-by-state breakdowns of the scoring, more information can be obtained at FOR MORE INFORMATION: n About teenage pregnancy in the U.S., see n n n n n About the rate of unintended pregnancies in the U.S, see About state abortion restrictions, see About State Medicaid Expansions, see About state Medicaid family planning waivers, see spib_smfpe.pdf About sex education requirements at the state level, see spibs/spib_se.pdf ACKNOWLEDGEMENTS: We also wish to express our deep appreciation to the Guttmacher Institute, the Kaiser Family Foundation, Planned Parenthood Federation of America, and other organizations working in this field for the research and reporting that made this report card possible nd St, NE, Washington, DC I Phone: I www. populationinstitute.org