Why Family Planning, Why Now?
VIA NFPRHA National Family Planning and Reproductive Health Association
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.
What Does the Expanded Eligibility for Medicaid-Funded Family Planning Services Mean, Anyway?
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.
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 to care.
Why Is Legislation Necessary?
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.
Why Now?
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 time.
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.
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