Visits for contraception and cancer screenings at Planned Parenthood clinics have dropped by double-digits after Congress passed a bill cutting off Medicaid funding to certain reproductive health care providers last year, according to a new Democratic congressional report.

Between July 1 and the end of December, the report said emergency contraception distribution fell 10%, oral contraception distribution fell 27%, and IUD insertions fell 10%.

Republican members of the House and Senate passed a sweeping budget reconciliation bill in July that included a one-year provision barring clinics from receiving federal Medicaid reimbursement if they offered abortion services and billed Medicaid more than $800,000 in fiscal year 2023. The rule largely affected Planned Parenthood because of the high dollar amount, but some large independent clinics were also affected, such as Maine Family Planning and Health Imperatives in Massachusetts.

Since July, Planned Parenthood reported 20 clinics were forced to close because of the cuts. That was in addition to numerous clinics that had to close after the loss of Title X funds and other factors, bringing the total to 51 last year. The report said nearly 75% of those closures were in rural, medically underserved areas. About half were in the Midwest, including Indiana, Michigan and Ohio, affecting about 25,000 patients.

“Almost all, 48 of 51, that closed between January and December offered primary care, and nearly half were in primary care shortage areas,” the report said.

In recent months, the decline in services grew. The report also notes there were 20% fewer visits for birth control pills in November, and a drop of 36% for intrauterine devices in December, the steepest decline out of all services measured. Some clinics have reported dropping their IUD offerings because it is a costly birth control device to obtain that was normally covered by Medicaid, but it is also the most popular and preferred form of birth control.

The number of visits for breast cancer screening exams fell by 25% in December, according to the report, and testing for sexually transmitted infections fell 11% in November, both of which could result in delayed treatment that increases overall health care costs.

Twelve states have committed their own funding to help address the gap from federal Medicaid cuts, amounting to about $300 million, according to the report. That includes California, Colorado, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Nevada, New Jersey, New Mexico, New York, Oregon, and Washington. But advocates for Planned Parenthood say it still leaves a significant shortfall, because health centers nationwide provided an estimated $700 million in care annually to Medicaid patients before the law went into effect.

U.S. Sen. Ron Wyden, a Democrat who represents Oregon and a ranking member of the Senate Finance Committee, said at Thursday’s press conference that he will vigorously oppose any reconciliation efforts to make the cuts permanent.

“We’re here to tell people who are opposing access to health care for women, no way. It’s not going to happen on my watch at the Finance Committee, period. Not going to happen,” Wyden said.

Federal law already prohibits providers from using federal dollars to pay for abortion care, with limited exceptions. Medicaid dollars paid for all of the other types of care that clinics provide, including contraception, testing and treatment for sexually transmitted infections, and screenings for breast and cervical cancer. Maine Family Planning also provided primary care services to about 1,000 patients statewide, but had to halt that program in October because of the cuts.

“The report makes clear that it actually costs money to see all these Planned Parenthood offices or providers close, and once they’re closed, it’s not as though you can just bring them back up,” said U.S. Sen. Mazie Hirono, a Democrat who represents Hawaii, at a news conference Thursday morning. “But once they’re closed, people still need this kind of care, and so they’re going to go to other providers, or they will go without — which results in undiagnosed illnesses and health care needs.”

Planned Parenthood Federation of America and two of its affiliates sued to block the law, but the effort was unsuccessful. Republicans in Congress have signaled a goal of extending the cuts and making them permanent, as outlined in the Republican Study Committee’s framework for the next budget reconciliation bill, released in January.

A coalition of major anti-abortion advocacy organizations, including Live Action, Heritage Action, National Right to Life and Susan B. Anthony Pro-Life America, signed a letter sent to House Republican leadership urging them to immediately begin the reconciliation process and make the cuts permanent.

“Since the enactment of the 2025 reconciliation law, multiple abortion businesses have already closed facilities or scaled back operations, demonstrating the measurable impact of the defunding provision,” the letter said.