Proposed birth control rule gets politicized
When President Barack Obama succeeded last week in urging Democrats in the U.S. House of Representatives to pull a family planning provision from his proposed economic stimulus package, he aimed to reach across the aisle to House Republicans who had argued the element of the package did not relate to improving the economy.
But experts who study reproductive health policy say the provision was wildly misrepresented by both legislators and the mainstream media, who painted the minute element of the $819 billion package as a drastic change and irresponsible use of money, rather than a mere streamlining of existing policy.
"The bottom line is that it could save states money by preventing taxpayer-funded births," said Rochelle Tafolla, the spokeswoman for Planned Parenthood of Houston and Southeast Texas. "States know they save money with this program, that's why it already exists."
According to Adam Sonfield, a senior public policy associate for the Guttmacher Institute in Washington, D.C., 27 states have already applied for and been approved to extend family planning services through Medicaid. In Texas, this includes women at up to 185 percent of the poverty level.
But in Texas less than 10 percent of women who qualify for the family planning assistance are enrolled in the program.
Under the provision, states like Texas would merely skip the reapplication process to continue to provide contraception to women who seek it.
States that have not applied for the provision would not need to, eliminating years of reviews and paperwork, and expediently providing birth control to women who want to prevent an unintended pregnancy in an unpredictable economic climate.
Contrary to popular belief, the provision wouldn't have been felt on a local level until 2012, when Texas must reapply for permission to provide birth control through Medicaid.
Sonfield says that because the provision is difficult to explain in the space of a sound bite, it's been misconstrued and used as a scapegoat.
"That's one of the reasons it turned out so poorly," Sonfield said. "It's simply giving the states the option to do something that more than half have already chosen to do."
House Minority Leader John Boehner, R-Ohio, was quoted as saying the bill would cost the federal government hundreds of millions of dollars. In fact, the dollar amount was absent from the stimulus package, which instead pointed to $700 million in savings over a 10-year period.
It may take a year for the program to pay off, since a higher demand for birth control that would follow the change, but over time it would save dollars in deliveries, healthcare, and education costs for women who don't want to have another child.
Furthermore, experts agree that the precise financial savings in health care costs miss the point.
"Saving money is good in the short run, but that's not why it was part of the stimulus package," Sonfield said. "It was there because it helps women to be part of the economy, it helps them finish school and continue to be part of the workforce when they can no longer afford birth control."
Tafolla, of Planned Parenthood, says the detriment to Texas women is more subtle. Since less than 3 percent of women eligible to receive birth control through Medicaid in Texas do so, by including the provision in the package, more women would have been alerted through media coverage of the change.
The $50,000 allotted by the state to promote the program is gone, and in poor pockets of Texas like the Rio Grande Valley where a high percentage of women qualify, clinics must simply make it their business to alert every caller, every friend and every patient of the program.
Tafolla worries that the media coverage of Obama's repeal of the global gag rule, which gives organizations that discuss or provide abortion funding for non-abortion related activities abroad, conflated that change with funding abortions, as Boehner has claimed. If the trend continues, more family planning objectives that prevent abortion could also be misrepresented.
"The global gag rule money had nothing to do with abortion, but saying it does is an easy way to throw family planning off course and make people think, ‘this is ridiculous, why are we spending money on this.' The fact is, 56 percent of the births in Texas are paid for by Medicaid."
In the end, not a single House Republican voted for the stimulus package, even without the family planning provision.
"This program has been demonized on Capital Hill," said Sonfield, the policy analyst. "But the fact is, it's a great program, supported by lots of conservative legislators across the country in the past. It's distressing to see it so completely misrepresented."
