Reproductive and sexual health services play an important role in daily life and wellbeing for many people. These services include preventive services (such as screenings for sexually transmitted infections and reproductive cancers), contraceptive services, and services relating to pregnancy and childbirth. The objective of this report is to provide national and state data on the use of reproductive and sexual health services among people with health insurance coverage through an employer, updated with data from 2021.

We use HCCI's commercial claims dataset to examine 11 services, which we categorized into contraceptive services, sterilization, and services related to termination of pregnancy. For each, we assess overall volume of services and rates in the eligible population, nationally, by state, and by age group. The report measures use as the number of services received and not the number of people currently using a given service or product.

Findings include:

• Contraceptive services were widely used. We found a combined rate of contraceptive services (oral pill, ring, injectables, intrauterine devices, implants) of almost 250,000 per 100,000 reproductive aged females nationally in 2021.
• Nationally, tubal ligation sterilization services declined since 2017. Vasectomy rates increased from 2017 to 2019, dropped substantially in 2020, and rose again in 2021.

Pregnancy termination services fluctuated over time; the overall rate of these services in 2021 was 661 per 100,000 reproductive aged females. The highest rates of these services were among females aged 25-34.