The Nation Magazine, December
By Bryce Covert
Conservatives have long painted themselves as the guardians of fiscal sanity. But they have also fashioned themselves as the guardians of the innocent babies being preyed upon at Planned Parenthood. Even though abortions make up just 3 percent of the services Planned Parenthood providesand many clinics dont provide them at all because of restrictions placed on the funding they receiveconservatives have long held a legislative grudge against the organization and have even broadened their contempt to other family planning clinics.
That deep-held distaste for womens health providers led Texas lawmakers last year to slash $73 million from all of its family planning services and shift the money to other areas of the budget. This blunt instrument hit all of the states womens health providers, but was meant to target Planned Parenthood and deny it taxpayer dollarseven though the clinics that received state subsidies for care never performed abortions.
This may be in line with their staunch opposition to what they see as a baby-killer, but that ideology comes with quite the price tag. News has surfaced that for the two-year period between 2014 and 2015, poor women are expected to deliver nearly 24,000 babies that they wouldnt otherwise have had if they had access to state-subsidized birth control. Those extra births will cost taxpayers as much as $273 million, with between $103 million to $108 million of that hitting the states general revenue budget alone. Much of the cost comes from caring for those infants through Medicaid.
Lawmakers may not care about what this means for the lives of the low-income women who are now bearing and raising children whose births they would have otherwise prevented had they had access to contraception. But conservatives, the fiscally responsible party, are now thinking twice about the budgetary implications. The New York Times reported last week that a bipartisan coalition is considering ways to restore some or all of those family planning dollars, as a cost-saving initiative if nothing else. Its not like the budget hit should come as a surprise, however. When the cuts were initially debated, an estimate was circulated that they would lead to an extra 284,000 births at a cost of $239 million. Yet the cuts passed, a price that socially conservative legislators were willing to pay in their referendum on Planned Parenthood, as the Times reports.
And unfortunately, the ideological battle against Planned Parenthood will not be brought to a complete cease-fire, even in the face of these stark numbers. Planned Parenthood will almost certainly be excluded from any reinstated family planning funding because of an existing ban against taxpayer money going to providers who are affiliated with clinics that perform abortions, even if they dont do so themselves. While there are other womens health providers in the state, RH Reality Checks Andrea Grimes set out to find out whether the hundreds of listings on Texass website actually provide the services women need. She found that many of them dont provide any kind of contraceptive care, dont take Medicaid Womens Health Program clients, or are simply misleading duplicate listings.
And the ones that do offer the right services likely wont be able to meet the huge increase in demand. Grimes cites a study that found that Planned Parenthood accounted for half of the states womens healthcare, serving nearly 52,000 clients. The remaining providers mostly serve ten or fewer patients. Thats just not going to cut it for all of the women who now need to find care.
Continuing to deny funding to Planned Parenthood will keep costing the state, even if other clinics see their funding reinstated. To the tune of an estimated $5.5 million to $6.6 million as a result of paying for the entire womens health program on its own, rather than receiving the 90 percent federal matching funds, as well as paying for a higher number of births that will have to be covered by Medicaid funds.
Texas is a huge state, so its case sticks out like a sore thumb. But its not the only one to go after family planning services and Planned Parenthood. As the Guttmacher Institute reports, last year some states felt compelled by the federal push to ban federal funds from going to Planned Parenthood to look at whether providers in their states that use private funding for abortion should be barred from receiving state funding or, in some cases, federal Medicaid reimbursements. Currently, six states prohibit some providers from receiving family planning funds and in three the restrictions apply to those that provide abortion or are affiliated with agencies that do.
So conservative lawmakers across the country will now be faced with a choice: save the babies or save the budget. Because its clear that you cant do both. Organizations that provide contraceptionand, it must be said, abortionsnot only do great service to the women who need to control their fertility and their lives. They do great service to taxpayers. By giving women access to contraception, publicly funded family planning organizations save us $3.74 for every dollar we spend in avoided Medicaid costs associated with unplanned births. Their services saved federal and state governments $5.1 billion in 2008.
As Texas has just found out, those arent imaginary numbers. They are very real. Whoever says that contraception and abortion arent economic issues should take a second look. They have a huge impact on womens financial situations. But, perhaps higher on conservatives checklist, they have an enormous impact on the budget.
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