Thankfully – and signaling progress in the area of sexual and reproductive health – one of the first bills introduced in the Senate on the opening day of the 110th Congress was the Prevention First Act (S. 21). This common-sense, cost-effective, health service approach to simultaneously reduce the incidence of abortion and promote good health was introduced by anti-choice Senate Majority Leader Harry Reid (D-NV).
Reid introduced a similar bill in the previous Congress (though it was doomed to go nowhere). We have crossed fingers that the makeup of the new Congress will enable a better outcome this time around.
While the bill might look like a laundry list of programs, it embraces a set of practical solutions – stalled over the past 12 years – to meet some of the most basic health needs that humans have:
- Contraception and family planning services through the national Title X program would grow from $283 million for FY 2007 to $699 million so that more services could be provided. While this seems like a huge leap, the new number simply reflects where Title X would be if funding had kept up with inflation since 1980.
- Medicaid family planning services would be available to women in an economic category that also makes them eligible for services related to pregnancy and child birth.
- Private health insurance plans would have to offer the same level of prescription drug coverage for contraception as they do for other drugs and services.
- Sexual assault survivors would receive factually accurate information about emergency contraception (EC) and access to EC in emergency rooms upon request.
- More people would learn about EC and its benefits, rather than be kept in the dark that this option is available.
- Funds would be available to establish or expand teen pregnancy prevention programs.
- And though it still amazes me this kind of legal language is required, the bill would ensure any program using our taxes to discuss contraception must be medically accurate.
- New to the Prevention First package is support for comprehensive sexuality education, as offered in the Responsible Education About Life (REAL) Act, which was offered, but languished, last Congress..
Simply put, Prevention First could turn the tide on unacceptably high rates of unintended pregnancies and sexually transmitted infections. Each year, half of all the pregnancies in the United States are unintended, which puts us at the high end of the rates among industrialized nations. Of these, 4 in 10 end in abortion. Lack of knowledge about and ways to prevention against sexually transmitted infections ends up creating about $19 billion in health care costs.
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Too often in our rich country, financial barriers keep people from being able to decide if, when and how many children to have – the basics of internationally-recognized reproductive rights. Most women rely on health insurance to cover the cost of family planning; in 2003, 1 in 5 American women of reproductive age did not have health insurance – more than in 2001. Many private health plans still do not cover contraceptive services and supplies. Direct federal support for services has waned – especially as abstinence-only-until-marriage advocates have demanded equal funding for those programs (never mind that health care services actually cost more than telling people not to have sex).
The Prevention First Act is evidence that at a small (but growing?) group of Senators believe that knowledge and information together with services, rather than lack of it – help people to make decisions good for their lives and health.