Why The GOP's Plans To Cut Family Planning Will Cost Us All
Just as many states accelerate efforts to defund family planning clinics, here comes news that nearly half of all pregnancies in the U.S. are unintended.
As one might expect, unplanned pregnancies have a higher likelihood of requiring maternity and infant care via public programs like Medicaid, vital programs which by their nature are paid for by taxpayers. That's why for decades, funding for family planning was considered common sense by conservatives as well as liberals--by funding birth control, you guaranteed that more families were planned and budgeted for. This logical commitment to family planning remained common sense (and common ground) until the religious right started a campaign against the so-called immorality of such programs, and co-opted the GOP's platform in the process. Since then, this extremist social agenda has led many to deliberately ignore the fact that slashing of public family planning services is actually fiscally irresponsible, putting a heavy burden on the very taxpayers Republicans claim to be so concerned about. New data shows the absolute irrationality behind the defunding of Planned Parenthood under the banner of "fiscal restraint."
The extent of the costs of unplanned pregnancies has never before been fully estimated until the Guttmacher Institute and the Brookings Institution released a series of reports last week—and the numbers they came up with are truly startling. Nationally, 64% of the 1.6 million births resulting from unintended pregnancies in 2006 (the most recent year data are available) were paid for by public programs, compared to 35% of births resulting from intended pregnancies. The clear deduction here: planned parenthood, with small ps, costs the state less. Of the $11.1 billion in government expenses for unintended pregnancy, $4.6 billion came from the states.
Betty Cockrum, CEO and president of Planned Parenthood of Indiana—which is the first network to be defunded by state law—told AlterNet that these costs are, in fact, even higher than they appear in the report.
“Uncounted are costs from increased likelihood of preterm birth, low birth weight, and other negative prenatal outcomes; children’s medical care beyond their first year; pregnancy-related care paid for by other government-related programs including indigent care programs that subsidize hospitals’ uncompensated care; and other government benefits, such as food stamps and welfare payments,” she said.
Indeed, the research team also emphasizes that $11 billion is a conservative estimate. They point to literature on teen pregnancy, for example, that accounts not only for medical expenses, but the fact that teen parents are more likely to drop out of school and claim public assistance from a young age.
But the numbers still stand in stark juxtaposition with state battles over funding for family planning services, particularly over Planned Parenthood.
Indiana Governor Mitch Daniels recently slashed all funds to 28 health centers throughout the state. Others swiftly followed his example. Legislators in Kansas, Tennessee, Texas, North Carolina, and Wisconsin all moved forward last week on budgets or bills that would strip funding from Planned Parenthood, or any organization that provides abortions or abortion referrals (even though it is already illegal to use any public funds to pay for abortions). Hospitals are typically exempted from these proposals. In related action, Oklahoma House members moved to deny Planned Parenthood from participating in the Women, Infants, and Children (WIC) program, which allows the clinics to provide nutrition vouchers for low-income families.
Pair this pattern with the fact that in nine states, the rate of unintended pregnancy is trending steadily upward, while in no state is there a consistent decline. Mississippi has the highest rate of unintended pregnancy, with California, Delaware, the District of Columbia, Hawaii, and Nevada falling closely behind. New Hampshire had the lowest rate, followed by Maine, North Dakota, Vermont, and West Virginia. Where rates of unplanned pregnancy are falling? Among high-income women.
At the same time, rates are rising for the poorest women. Of course, it is these women whose pregnancy and infant expenses are likely to rely on public insurance programs. As well, Hispanic women are twice as likely as white women to have an unintended pregnancy, while African American women are three times as likely.
Skeptics of family planning clinics might point to the report’s unsettling numbers and cite that as evidence that their efforts to reduce unintended pregnancies are not effective. Therefore, they might say, public funds should go elsewhere. Such an argument, however, would blur the lines of cause and effect. Guttmacher researchers Adam Sonfield and Elizabeth Nash told AlterNet in a joint statement that because of limited resources, “publicly funded family planning centers are currently able to serve only about 40% of women in need of their services.” In fact, investing about $2 billion in public funds on contraceptive services yields about $7 billion in gross public savings from avoiding unintended pregnancy.
“In other words,” they said, “in the absence of the that current investment, the public cost of unintended pregnancy in the United States would be about 60% higher than it is today.”
Put the data in context of the states that are the hot focal point of these bitter family planning battles. While these debates publicly center on abortion, opponents of these clinics ostensibly care about balancing budgets during difficult economic times. Let’s compare, then, how the costs for Planned Parenthood sit next to the costs of, well, unplanned parenthood in each state:
Number of all births: 88,600
Number of births from unintended pregnancies: 37,000
Percent of publicly funded births: 43.9%
Percent of publicly funded births from unintended pregnancy: 61.3%
Cost per publicly funded birth: $11,119
State cost for births from unintended pregnancy: $93.4 million
Total cost for births from unintended pregnancy: $252.4 million
Recent action: The law signed by Gov. Mitch Daniels prohibits state agencies from entering contracts with or making grants to “any entity that performs abortions or maintains or operates a facility where abortions are performed.” This cut off 9,300 patients covered by Medicaid from using Planned Parenthood, out of a total of about 85,000 patients served by 28 clinics. Most patients received contraceptives. “The state’s 2008 Medicaid report shows the cost of Medicaid-covered births approaching half a billion dollars. That number will continue to grow with (the law’s) diminished access to birth control,” said Betty Cockrum. Donations from around the world have permitted PPIN to extend care to Medicaid patients until at least May 30. PPIN and two of its patients filed suit in Federal District Court in Indianapolis; the next court date to seek injunctive relief on the law is June 6.
Officials from the Obama administration have said the Indiana law imposes impermissible restrictions on the freedom of Medicaid recipients to choose health care providers, and it may level sanctions against the state.
Number of all births: 41,000
Number of births from unintended pregnancies: 17,200
Percent of publicly funded births: 36.2%
Percent of publicly funded births from unintended pregnancy: 56.8%
Cost per publicly funded birth: $9,965
State cost for births from unintended pregnancy: $37 million
Total cost for births from unintended pregnancy: $93.6 million
Recent action: Both houses of the Kansas Legislature approved a 2012 budget bill that would redirect about $334,000 in federal family planning funds from Planned Parenthood to alternative clinics. It also passed a bill that makes the purchase of insurance riders necessary for women who need abortions, even for rape. Gov. Sam Brownback is expected to sign this into law.
Number of all births: 127,900
Number of births from unintended pregnancies 60,900
Percent of publicly funded births: 53.1%
Percent of publicly funded births from unintended pregnancy: 74.1%
Cost per publicly funded birth: $12,859
State cost for birth from unintended pregnancy: $211.6 million
Total cost for birth from unintended pregnancy: $579.6 million
Recent action: The House passed a budget this month that prohibits state grants, or federal grants that pass through the state, from going to any of Planned Parenthood’s nine North Carolina clinics, which serve 25,000 patients. The proposed cuts would also eliminate Planned Parenthood's Adolescent Pregnancy Prevention program. The budget is now in the hands of the Senate. Planned Parenthood’s North Carolina network has set up an online action site here.
Number of all births: 84,400
Number of unintended pregnancies: 43,500
Percent of publicly funded births: 53.3%
Percent of publicly funded births from unintended pregnancies: 67.9%
Cost per publicly funded birth: $11,647
State cost for birth from unintended pregnancy: $123.8 million
Total cost for births from unintended pregnancy: $343.7 million
Recent action: The Tennessee Senate passed a bill last week that would cut all Title X funding from "third party providers or private organizations or entities," which we can safely translate as signifying Planned Parenthood. While these Title X grants pay for contraception, STD and HIV screenings, and other services, none of these grants pay for abortion. Planned Parenthood estimates that the defunding in Tennessee would impact three clinics and about 9,000 patients. The bill is expected to pass the legislature and be signed by the governor in the next few weeks.
Number of all births: 399,600
Number of unintended pregnancies: 179,500
Percent of publicly funded births: 59.9%
Percent of publicly funded births from unintended pregnancies: 73.8%
Cost per publicly funded birth: $9,728
State cost for birth from unintended pregnancy: $507.1 million
Total cost for births from unintended pregnancy: 1.289 billion
Recent action: The legislature is currently grappling with budgets that severely restrict family planning funds. The House budget cuts funds that would likely go to Planned Parenthood services by more than $60 million. The Senate’s budget kept the family planning funds in tact, but the Senate Finance Committee is reported to be leaning toward the House’s numbers. In a separate cut, The Texas Tribune reports that state Sen. Bob Deuell (Republican) and Rep. Garnet Coleman (Democrat) “agree that the Medicaid Women's Health Program, operated under the Health and Human Services Commission with a 9 to 1 federal match, is likely dead.” The two legislators are partnering to renew the program that funds cancer screenings for low-income women, nearly half of which are provided at Planned Parenthood clinics. It is cost-effective: the Legislative Budget Board recommended expanding it. Instead, the Tribune indicates that program “appears to be circling the drain.”
Number of all births: 72,300
Number of births from unintended pregnancies: 27,700
Percent of publicly funded births: 36.1%
Percent of publicly funded births from unintended pregnancies: 51.8%
Cost per publicly funded birth: $10,694
State cost for births from unintended pregnancy: $66.6 million
Total cost for births from unintended pregnancy: $157.3 million
Recent action: The Wisconsin Joint Finance Committee voted to block state family planning grants from any organization that provides abortions or abortion referrals, even though those funds cannot legally be used to pay for abortions. The restriction, if finalized, would cut nearly $1 million a year from nine Planned Parenthood clinics around the state, which serve about 12,000 men and women, most from rural and low-income communities. The services supported by these grants include contraceptive supplies, pregnancy testing, cancer screenings, and STD/HIV testing. The committee also voted to drop men from the state family planning program that’s covered by Medicaid, and to lower the income eligibility threshold for the program.
It’s evident that reducing the number of unintended pregnancies leads to increased public savings. And it’s no secret about what it takes to minimize unintended pregnancy: comprehensive, medically accurate sexual education, and access to safe, reliable, and affordable contraception. In particular, the report’s researchers recommend using the data to “identify populations at increased risk of unintended pregnancy, allowing for targeted programs to improve reproductive health at the state level.”
Researchers further note that efforts to reduce unintended pregnancy solely by restricting access to abortion are less effective than efforts to increase use of contraceptives. “Preventing Planned Parenthood and similar clinics from serving women with Medicaid coverage or from otherwise providing publicly funded family planning services would neither reduce abortions nor save the state any money,” researchers Sonfield and Nash told AlterNet.
“Rather, Guttmacher research indicates that it would have the opposite effect, because publicly funded family planning services have been shown to help women avoid unintended pregnancies and the abortions that often result, and because every public dollar invested in family planning ends up saving nearly four dollars for the federal and state governments,” they said.
But despite the public calls for fiscal responsibility, Betty Cockrum of Planned Parenthood of Indiana doubts that the data about the public cost of unintended pregnancy will do much to tame the momentum to defund family planning clinics.
“Lawmakers here in Indiana were made very aware of the negative fiscal implications of eliminating funding to PPIN, both to the organization and long-term to the State of Indiana and society,” Cockrum told AlterNet. “They ignored the facts because they were focused on their goal to erode abortion rights in the state and try to force PPIN to stop doing abortions.”
Abortions make up only six percent of PPIN services, she added.