Cuts to Family Planning Won’t Help Jane the Plumber

Anna Clark

The presidential candidates have been challenged with the same question again and again: In our unprecedented economic crisis, what programs or services will you cut? If they cut family planning services, other reproductive health costs are sure to spiral leaving "Jane the plumber" without the critical health services she needs.

The presidential candidates have been challenged with the
same question again and again: In our unprecedented economic crisis, what
programs or services will you have to cut from the plans you have laid out for
our country? 

Perhaps it’s not a surprise that neither Sen. Barack Obama or Sen.
John McCain dwells too long on what, in particular, will lose its funding in the next
year. But truth may be revealed by omission; that is, an issue that the
candidates don’t discuss much on stump speeches, interviews and debates
probably isn’t their unqualified spending priority.

That should make those who use and support publicly funded
birth control – the "Janes" if you will – nervous.

There are 17 million American women who need subsidized
contraception services and supplies, including 4.9 million teenagers and 11.8
million adult women whose income is below or just above the federal poverty
line, according to the Guttmacher Institute.

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Lauren is one of them. The 20-year-old California native receives a reduced rate
for birth control through the Family Planning, Access, Care and Treatment
(FamilyPACT) program in her state. FamilyPACT provides no-cost reproductive
health services and contraception to men, women and teens of child-bearing age
and ability.

Lauren says that lots of her friends and family members
"have been just stoked to walk out of Planned Parenthood or their local health
department with whatever birth control they want, entirely free. It’s almost a
foreign concept." But she also said that the positive affects of FamilyPACT
reach far beyond any one individual’s pocketbook and peace of mind.

"(FamilyPACT has) been shown to reduce rates of unintended
pregnancy all around," she says. "It also allows people in California the rare
opportunity to have one aspect of their health completely taken care of, free
of charge. "

FamilyPACT is sponsored by the California government. Together, federal and
state governments spent $1.26 billion on family planning services and supplies
in FY 2001. The largest source of those funds: Medicaid, with $770 million
spent on reimbursing providers of medical care for the contraceptive services
they supply to those who need help to afford care.

Shalyn is an 18-year-old from California who receives a
reduced contraception rate through Medicaid.

"I think the impact is enormous and allows people to take their
health in their own hands," says Shalyn.

She too sees these services as under threat, however–a
threat that she says is caused by the myopia of those who aren’t directly
affected by the program.

"I get the feeling a lot of the people who do not receive
direct benefits from these programs think they are unnecessary and think it
wouldn’t be a bad idea to cut them drastically in times were money is tight,"
she says.

Without the support of Medicaid for reproductive health
services, "some people would probably resort to methods that are free, but are
not as effective, like pulling out," Shalyn says. "Unwanted pregnancies and
welfare rates would go up. The people who get help from these programs can’t
pay for their own medical care, [so] how are they supposed to pay for prenatal
care and an unplanned child?"

While Medicaid has a broader health focus, Title X of the
Public Health Service Act stands out as the only federal program exclusively
dedicated to family planning. Fifteen percent of all public funding for family planning
comes from Title X, which, in FY 2001, translated into $189 million. According
to the Guttmacher Institute, Title X serves men and women "who do not meet the
narrow eligibility requirements for coverage under Medicaid, and sets standards
for the provision of family planning services, ensuring that care is voluntary,
confidential and available on a sliding-fee scale or free for the poorest of
the poor."
Funding for Title X is 61% lower today than it was in 1980, when inflation is taken into account, says Guttmacher. An annual Congressional appropriation provides the core funding for
Title X programs. This appropriation, plus Medicaid reimbursements and
other Federal sources account for more than half of Title X-funded
clinics’ operational funds.

Each dollar invested in Title X family planning saves $3.80 in Medicaid costs for pregnancy-related health care, including care of
newborns.

Without publicly funded birth control and services, Lauren
sees a daunting future for her community, where "young and older adults alike
wouldn’t be able to afford contraception … I think pregnancy and STI rates would
shoot through the roof. … There’s no way in hell many women will be willing to
be prodded in stirrups when they’ll have to pay an arm and a leg for it, then
be sent home with a $420+ prescription for a year of birth control pills."

The threat of that future, though, is uncomfortably present.
The last time Lauren went to her clinic, the place was plastered in fliers that
urged visitors to write letters to their lawmakers, asking them not to cut
funding for FamilyPACT. Not to mention the more coded threat encroaching on
their work: Lauren has noticed the tendency for crisis pregnancy centers to set
up shop quite close to the clinics that offer a full–and honest–scope of
reproductive health services.

In Washington, Rewire’s Heather Corinna participates in a program similar to FamilyPACT. It’s called Take Charge, and
Corinna says that its reproductive services are particularly crucial for minors
who are uninsured, who aren’t eligible for their parents’ insurance coverage,
or who don’t feel comfortable or safe using their parents’ insurance for sexual
health care.

"The most effective methods of contraception are costly,
particularly those like the implant or an IUD, which means one payment of several
hundred dollars upfront," Corinna says.

But through Take Charge, Corinna says, those people who are
in the greatest need of contraception, but have the lowest income level, can
still obtain reliable forms of birth control.

Instead of being embraced as a standard for all of
Washington’s citizens, this publicly funded program is also subject to
political and economic pressures. 
Corinna reports that "it really depends largely on the governor’s race
this year: if Dino Rossi wins, this (program) absolutely will be under
threat.  If Christine Gregoire does, I
think it will easily be protected. "

But the security of the program depends on the White House
as well.

"[President] Bush not only cut family planning
funding over the last eight years; he consistently put individuals in positions
of power with that program who patently and openly did not support the very
service it is supposed to provide, [people] who were anti-contraception,"
Corinna says. "I have no reason to believe that a McCain/Palin win would not
continue the same sorts of practices."

Should reproductive health services be knifed under the
leadership elected on November 4, Corinna says she’ll find herself without the
yearly check-ups she needs. What’s more, she believes that "there certainly are
many, many women here who would be far more hurt by the loss of this program
than myself."

The numbers are astonishing: even with uncertain footing,
publicly supported contraceptive services "help women prevent 1.3 million
unplanned pregnancies, which would result in 632,300 abortions, 533,800 unintended
births and 165,000 miscarriages," according to the Guttmacher Institute. If
these programs didn’t exist, there would be a 40% increase in the number of
abortions in the U.S.

It must be acknowledged that publicly funded contraception
and sexual health services are hardly without their troubles, outside of
uncertain funding and political support. Some people who abuse the mission of
these programs to serve under-resourced individuals.

Lauren says that at her clinic in California, the program
runs on an "honor system" that patients can abuse.

"When you go, they ask you to self-report your income and
family size," Lauren says. "Even if they see that you’re covered under an
insurance policy, it’s common knowledge that all you have to say is ‘My parents/partner
can’t know I’m here,’ and you get services for free."

Lauren says that her mother encouraged her to take advantage
of the system.

"My mom knew I was sexually active at one point and told me
to go to the health department because she didn’t want to pay for my pills,"
she says.

Internal problems notwithstanding, the solution is hardly to
decimate the state and federal funding that family planning programs depend on
to serve low-income people. The nagging numbers reveal that while services need
to improve, they certainly must exist, if not be expanded into a standard of
healthcare and human rights.

Research proves, for example, that without publicly funded
contraceptive services, an additional 386,000 teens would become pregnant,
increasing the rate of teenage births by 25% and teenage abortions by 58%.

It’s a direction that nobody wants our society to go in.
But, when family planning barely musters as a talking point for most candidates
for elected office, when the dollars are draining from every sector in the
nation, how could we possibly change the direction we may be headed?

Shalyn and Lauren both have ideas for how we need to take
action.

"People need to stop thinking of health care as a commodity,"
Shalyn says. "People need to realize that birth control and yearly paps and
reproductive care are really important parts of life–personally, socially,
economically, holistically."

"We must elect a president who is pro-choice and
pro-contraception, and continue fighting in our own states to either keep or
improve the coverage we have, or demand a family planning program where one
doesn’t exist," Lauren says. "We first and foremost must support Planned
Parenthood and independent, feminist, women-run health clinics that fight and
flounder every day to make sure money is no factor for women having a voice in
their reproductive health in states with an anti-choice political atmosphere."

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

News Abortion

Study: United States a ‘Stark Outlier’ in Countries With Legal Abortion, Thanks to Hyde Amendment

Nicole Knight Shine

The study's lead author said the United States' public-funding restriction makes it a "stark outlier among countries where abortion is legal—especially among high-income nations."

The vast majority of countries pay for abortion care, making the United States a global outlier and putting it on par with the former Soviet republic of Kyrgyzstan and a handful of Balkan States, a new study in the journal Contraception finds.

A team of researchers conducted two rounds of surveys between 2011 and 2014 in 80 countries where abortion care is legal. They found that 59 countries, or 74 percent of those surveyed, either fully or partially cover terminations using public funding. The United States was one of only ten countries that limits federal funding for abortion care to exceptional cases, such as rape, incest, or life endangerment.

Among the 40 “high-income” countries included in the survey, 31 provided full or partial funding for abortion care—something the United States does not do.

Dr. Daniel Grossman, lead author and director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California (UC) San Francisco, said in a statement announcing the findings that this country’s public-funding restriction makes it a “stark outlier among countries where abortion is legal—especially among high-income nations.”

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The researchers call on policymakers to make affordable health care a priority.

The federal Hyde Amendment (first passed in 1976 and reauthorized every year thereafter) bans the use of federal dollars for abortion care, except for cases of rape, incest, or life endangerment. Seventeen states, as the researchers note, bridge this gap by spending state money on terminations for low-income residents. Of the 14.1 million women enrolled in Medicaid, fewer than half, or 6.7 million, live in states that cover abortion services with state funds.

This funding gap delays abortion care for some people with limited means, who need time to raise money for the procedure, researchers note.

As Jamila Taylor and Yamani Hernandez wrote last year for Rewire, “We have heard first-person accounts of low-income women selling their belongings, going hungry for weeks as they save up their grocery money, or risking eviction by using their rent money to pay for an abortion, because of the Hyde Amendment.”

Public insurance coverage of abortion remains controversial in the United States despite “evidence that cost may create a barrier to access,” the authors observe.

“Women in the US, including those with low incomes, should have access to the highest quality of care, including the full range of reproductive health services,” Grossman said in the statement. “This research indicates there is a global consensus that abortion care should be covered like other health care.”

Earlier research indicated that U.S. women attempting to self-induce abortion cited high cost as a reason.

The team of ANSIRH researchers and Ibis Reproductive Health uncovered a bit of good news, finding that some countries are loosening abortion laws and paying for the procedures.

“Uruguay, as well as Mexico City,” as co-author Kate Grindlay from Ibis Reproductive Health noted in a press release, “legalized abortion in the first trimester in the past decade, and in both cases the service is available free of charge in public hospitals or covered by national insurance.”