Analysis Race

Health Reform’s Quiet Victory: Pregnancy Assistance Fund Benefits Vulnerable Populations

Sheila Bapat

An under-the-radar provision of the Affordable Care Act, the Pregnancy Assistance Fund, demonstrates the economic justice potential of health reform.

Shauna Humphreys has been leading programs that serve at-risk teens of the Choctaw Nation in Oklahoma for several years. But the impact of her work has increased dramatically over the past two years because of the Pregnancy Assistance Fund (PAF), a provision of the Affordable Care Act supporting a range of services for pregnant teens and young adults.

Humphreys’ program, known as Support for Pregnant and Parenting Teens (SPPT), serves nearly 100 Choctaw mothers under the age of 22 by building their parenting skills, providing sex education to help prevent repeat teen pregnancies, and encouraging young mothers to obtain high school degrees and pursue higher education.

Vastly more robust than the program Humphreys ran prior to receiving a 3-year PAF grant at $900,000 per year, SPPT is staffed with six caseworkers who visit clients’ homes monthly to deliver parenting and life skills training. Caseworkers also serve as a general support network for young women who are experiencing domestic violence.

“These young women need this level of support. They typically don’t have anyone helping them to meet their personal goals,” said Humphreys, herself a mother of twins. “I can’t imagine being pregnant in high school and trying to figure out my life after having a child.”

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While the battle over the ACA rages on in the states, with the Medicaid expansion and the birth control benefit persisting as the most contentious provisions of the law, PAF is an under-the-radar boon of health reform. Needless to say, if the ACA is repealed, PAF will likely be eliminated as well–jeopardizing Humphreys’ program and all PAF-funded programs.

Humphreys’ program is one of 17 PAF-funded programs throughout the country that help young parents and their children overcome hurdles that can limit life opportunities and and perpetuate poverty. States and Native American tribes are eligible to receive PAF funding. PAF was written into the health reform law that passed in 2010, and last year the program was expanded to a $25 million grant program through 2019.

United States rates of teen pregnancy, while declining steadily over the last decade, continue to be high compared with other developed countries. Native American communities consistently see higher teen pregnancy rates than other ethnic groups in the United States.

PAF’s focus is holistic — it funds programs that serve pregnant women who are victims of intimate partner violence and sexual assault. This resource is critical for all communities, and particularly for Native American communities: According to the Center for American Progress, Native Americans are victims of rape or sexual assault at more than twice the rate of other racial groups.

Clients of SPPT who have experienced domestic violence often confide in Humphreys’ caseworkers, who then refer the clients to domestic violence programs that offer shelter and other resources. “Our caseworkers hear about the range of difficulties clients are experiencing and that’s good, we want that, because we want to help in all aspects of their lives,” Humphreys said.

Equally critical is PAF’s focus on education, as children of teen parents are more likely to grow up poor if their parents do not at least make it through high school. For example, the Virginia Department of Health received a $1.5 million PAF grant to aid pregnant and parenting students in colleges and universities, helping them navigate the hurdles to staying in school and obtaining a four-year degree.

Quietly aiding some of the most vulnerable US populations, PAF demonstrates the economic justice potential of the ACA. As long as the ACA is not repealed in full by Congress or a Republican administration, PAF should be intact through 2019. Senator Bob Casey of Pennsylvania sponsored the bill to expand funding for PAF last year — I reached out to Casey’s office for comment about how a repeal of the ACA could impact PAF but haven’t yet heard back.

PAF and the work of its grantees makes the political wrangling over health reform seem completely petty. Writer Sarah Kliff recently pointed out that states’ opposition to the ACA is just as political as it seems, driven primarily by state leaders’ party affiliation. As it happens, none of the 17 states where PAF funding has been disseminated currently plan to oppose the Medicaid expansion.

So while the funding lasts, Humphreys and her team are hard at work. “We hope to hire more caseworkers and serve more women,” said Humphreys. “I don’t want to think about what could happen to these young women if our program loses support.”

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