Attacks continue on family planning funds

By Adam Sonfield
Senior Public Policy Associate
Guttmacher Institute
Washington, DC

The last several years have brought unprecedented attacks on the publicly supported family planning effort in the United States.

At the federal level, the House of Representatives voted in 2011 and 2012 to eliminate all funding for the Title X family planning program, the first such successful votes in the program’s history.¹ The same legislation included a separate provision that would have barred Planned Parenthood affiliates from receiving any federal funds, including reimbursement for services provided to women and men insured through Medicaid. Both provisions were rejected by the Senate and by President Obama. Nevertheless, funding for Title X has dropped by $36 million, more than 11%, between FY 2010 and FY 2013.²

Social conservatives’ efforts have been more successful at the state level. Between 2010 and 2013, 13 states enacted laws attacking family planning programs or providers, by disproportionately slashing family planning funding, barring or disfavoring certain types of health centers in eligibility for family planning grants, or barring such health centers from receiving reimbursement under Medicaid.³ Many of these laws have been challenged in court, and the Obama administration has interceded to protect the right of Medicaid enrollees to receive services from the family planning provider of their choice.

Cuts undermine care

When successful, these attacks have undermined women’s health and state budgets. In Texas, for example, the state in 2011 enacted severe family planning budget cuts and restrictions on providers’ eligibility for public funds. The result has been closed health centers, reduced access to affordable and confidential care, government savings from family planning services being cut by more than half, and an estimated 30,000 additional unintended pregnancies in 2012. Indeed, the consequences have led the legislature to reverse course and restore some of the cut funding.^4,5

All of these attacks are shortsighted and counterproductive when it comes to reducing the need for abortion or saving government funds. The latest evidence comes from a Guttmacher Institute report estimating the need for, extent of, and benefits from the U.S. publicly funded family planning effort in 2010.⁶ That year, a total of 8.9 million women received publicly supported contraceptive services, including 6.7 million women served by health centers and 2.2 million receiving Medicaid-funded care from private doctors.

The contraceptive services provided to these women helped them prevent 2.2 million unintended pregnancies in 2010, which would have resulted in 1.1 million unplanned births and 760,000 abortions.⁶ Without publicly funded contraceptive services, the rate of unintended pregnancies, unplanned births, and abortions in the United States would all be 66% higher. The rates for teens would be 73% higher. By helping women avoid unintended pregnancies and the maternity and infant costs that would have followed, public funding for contraceptive services in 2010 resulted in net public savings of $10.5 billion, or $5.68 for every dollar spent providing contraceptive care.

Title X is crucial

The Title X program was central to this effort, with Title X-supported health centers serving 4.7 million women in 2010. Those services helped women avert 1.2 million unintended pregnancies, 590,000 unplanned births, and 400,000 abortions, and they resulted in $5.3 billion in net savings.⁶ In addition, according to the Title X program’s 2011 annual report, these health centers tested 2.5 million clients for chlamydia and provided 2.7 million tests for gonorrhea, 744,000 for syphilis, and 1.3 million for HIV.⁷ They also provided 1.4 million clients with Pap tests to detect early signs of cervical cancer and 1.9 million women with breast exams to detect warning signs of breast cancer.

Despite the objections of social conservatives, Title X and other sources of public funding for family planning services will be just as critical in the years to come. The network of safety-net health centers, and the grant funding to support that network, will be needed to ensure that women and men newly insured under healthcare reform have a place to go for high-quality care. Moreover, many of these providers are well-situated to connect the uninsured to healthcare coverage and to care for the people who are left out of healthcare reform’s coverage expansions.

REFERENCES

1. Gold RB. Besieged family planning network plays pivotal role. Guttmacher Policy Review 2013; 16(1):13-18.
2. Guttmacher Institute. Memo on Title X funding from Kinsey Hasstedt to interested parties, July 26, 2013.
3. Guttmacher Institute. Laws affecting reproductive health and rights: State trends at midyear, 2013. Accessed at http://bit.ly/13R0FGI.
4. Aaronson B. Legislature restores some family planning cuts, New York Times, Aug. 8, 2013: A15.
5. University of Texas Population Research Center. TXPEP Family Planning Data Finder. Accessed at http://bit.ly/17sWRvW.
6. Frost JJ, Zolna MR, Frohwirth L. Contraceptive Needs and Services, 2010. New York: Guttmacher Institute; 2013. Accessed at http://bit.ly/15rD0fB.
7. Fowler CI, Lloyd S, Gable J, et al. Family Planning Annual Report: 2011 National Summary. Research Triangle Park, NC: RTI International; 2012. Accessed at http://1.usa.gov/13R2yn1.