Much hay has been made about contraception
this week, some good, most of it bad. If you have not heard by
now, there was a provision in the House version of the economic stimulus
package that would have expanded eligibility for Medicaid-funded family
planning services, which was stripped out after House Republicans threw
a fit about spending "hundreds of millions of dollars on contraceptives."
They claimed that their outrage was over the connection – or lack
thereof – between funding for contraceptives and stimulating the economy,
but the truth is far less complicated. Minority Leader Boehner
and his friends simply do not like contraception, and they really, REALLY
do not want you to be able to access it.
Before we delve too deeply into the
misguided hatred of all things contraceptive, let’s take a moment
to clear up some of the myths they have perpetuated this week about
the provision they lobbied so hard to destroy.
"expanded eligibility for Medicaid-funded family planning services"
Right now, Medicaid – the government’s
way of paying for health care for low-income women and men – provides
funding for pregnancy-related care for women whose incomes are up to
a certain percentage of the federal poverty level (roughly $17,600
for a family of three). The provision that was stripped out of
the House bill would have allowed states to provide family planning
services to anyone who, based on their income, would be eligible for
pregnancy-related care under Medicaid. In other words, if you
would qualify for pregnancy-related care under Medicaid, you would also
qualify to access family planning services, including contraceptives,
if you do not wish to become pregnant.
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Why is family planning important?
Family planning services – counseling,
contraception, sex education and preventive health services – are
a critical element of basic health care that helps women and men make
socially responsible decisions and build strong families. Contraception
is basic health care for women throughout much of their lives – an
average woman who wants two children will spend five years pregnant
or trying to get pregnant and roughly 30 years trying to prevent pregnancy. Publicly supported family planning
services help to prevent at least 1.4 million unintended pregnancies
every year, thus reducing
the need for abortion.
Why is Medicaid coverage of family
planning a good thing?
Bottom line: Medicaid coverage of family
planning is good health care policy that saves the government money.
That’s right, SAVES money. According to the Guttmacher Institute,
every $1 spent on publicly funded family planning saves more than $4 in state
and federal dollars. The
Congressional Budget Office (CBO) evaluation of the House stimulus bill
found that the Medicaid family planning expansion provision would have
saved the federal government $200 million over 5 years and an astonishing $700 million over 10 years. These numbers do not even include the
substantial savings state governments also realize, all while providing
essential health care to millions who would otherwise have no access
Right now, 27 states have obtained
a waiver from the federal government to expand eligibility for family
planning services; 20 of those states have obtained a waiver that allows
them to do the kind of income-based expansion that the stimulus provision
would have allowed. The problem with waivers, however, is that
obtaining one requires states to navigate a burdensome bureaucratic
process which lasts an average of 15 months, and that is just from the
point of submitting their paperwork. It can often take years for
a state to collect the information needed and put together the waiver
application, all at a significant investment of staff time and resources.
As the economic crisis worsens, employers
are being forced to lay off staff and slash benefits for remaining employees,
leaving more and more Americans reliant on the health care safety net
for basic health care services, including family planning and reproductive
health care. Federal investments in family planning pay huge dividends,
both in improved health and in cost savings, at a time when America
is in desperate need of both. Furthermore, many states with family
planning waivers have found that the additional resources made available
to providers has allowed them to hire new staff and expand clinic hours
– creating jobs and serving additional patients in need at the same
So why all the controversy?
That really is the question of the
hour, especially when this provision has already passed in the House,
back in 2007 as part of the CHAMP Act. Why would Mr. Boehner and
his like-minded colleagues be so opposed to including this important
provision in the stimulus package? The vehement opposition to
a provision that would enable states to provide quality, essential health
care to millions of women, all the while creating jobs AND saving the
government precious tax dollars is beyond the limits of reason… until
you realize that reason has nothing to do with it.
This attack on contraception is just
the latest in a long line of attacks on family planning. Let there
be no doubt that the War on Contraception is alive and well in America,
and there are no signs of it easing up any time soon. So what
should our next step be? Should we continue to try and placate
a small yet vocal minority who refuses to understand that family planning
saves money, reduces unintended pregnancies and is critical health care
for women? Or should we chart a new and bolder course, one that
places the needs of women above the rhetoric and the attempts at compromise.
I say yes, the time has come for Congress
and the Administration to do what they know to be right. We must
increase federal funding for family planning, starting with passing
legislation expanding eligibility for Medicaid-funded family planning
services, and we must do it today.