Report urges boost for U.S. family planning program
By David Crary
NEW YORK — Publicly funded family planning prevents nearly 2 million unintended pregnancies and more than 800,000 abortions in the United States each year, saving billions of dollars, according to new research intended to counter conservative objections to expanding the program.
The data is in a report being released Tuesday by the Guttmacher Institute, a reproductive-health think tank whose research is generally respected even by experts and activists who don’t share its advocacy of abortion rights.
Report co-author Rachel Benson Gold called the family planning program "smart government at its best," asserting that every dollar spent on it saves taxpayers $4 in costs associated with unintended births to mothers eligible for Medicaid-funded natal care.
Despite such arguments, federal funding for family planning is a divisive issue.
Last month, under withering Republican criticism, House Democrats abandoned an attempt to include an expansion of family planning services for the poor in the economic stimulus bill. One anti-abortion activist, Troy Newman of Operation Rescue, called the short-lived proposal a "shameful population control program that targeted low-income families."
However, Democrats in Congress are not abandoning their overall goal. They plan to push soon for a major funding increase for Title X, the main federal family planning program, as part of broader legislation endorsed by President Barack Obama to reduce the number of unintended pregnancies.
The Guttmacher report provides ammunition for those who will advocate the funding increase.
Surveying data from the 2006 fiscal year, the report says the national family planning program prevented 1.94 million unintended pregnancies, including almost 400,000 teen pregnancies. Based on statistical analysis and projections, these pregnancies would have resulted in 860,000 unintended births, 810,000 abortions and 270,000 miscarriages, according to the report.
Without publicly funded family planning, it said, the U.S. abortion rate would be nearly two-thirds higher, and nearly twice as high among poor women.
—More than 9 million women — including nearly 2 million under 20 — received publicly funded contraceptive services in 2006.
—Six in 10 women who use a family planning center consider it their basic source of health care. The services they receive often include pelvic and breast exams, tests for HIV, screenings for reproductive cancers, high blood pressure and diabetes, and referrals to other health providers.
—Public expenditures for family planning in 2006 totaled $1.85 billion, with 71 percent of the funds coming from the joint federal-state Medicaid program. Twenty-seven states have expanded eligibility for family planning for low-income women who otherwise wouldn’t qualify for Medicaid.
"States as varied as Texas, New York, South Carolina and Missouri have decided to undergo the cumbersome and time-consuming process to seek federal permission, known as a waiver, to expand family planning services," said Gold. "It’s a popular policy because it helps women while saving public dollars. It more than pays for itself."
The report recommends that Congress eliminate the waiver requirement and allow states to use the same income criteria to determine eligibility for family planning under Medicaid that they use to determine eligibility for pregnancy-related care. It also recommends lifting a ban on family planning coverage for legal immigrants in their first five years in the United States.
The report also endorses pending congressional legislation that would increase funding for Title X family planning. Some advocacy groups hope to more than double the current funding to $700 million a year.
Some conservatives, however, dislike Title X because one of its big recipients is the Planned Parenthood Federation of America, a major provider of abortions as well as family planning services. Title X funds cannot be used for abortions, but critics contend the federal money frees up other Planned Parenthood funds for its abortion services.
"It’s another Planned Parenthood bailout," said Tony Perkins, president of the conservative Family Research Council. "It covers their overhead."
He also expressed concern about the concept of public funding of contraception for unmarried people.
"The issue is whether taxpayers should fund, and thereby encourage, behavior that’s risky and morally questionable," he said.
One of the Democrats leading the push for more family planning money, Rep. Diana DeGette of Colorado, bristles at such criticism.
"Right-wing Republicans continually use sex as a weapon when they don’t have an effective argument to stand on," she wrote earlier this month. "They attack commonsense policies that not only save taxpayers money, but also promote public health."
Adam Sonfield, a Guttmacher policy expert who co-authored the new report, said the institute is concerned by statistics showing low-income and minority women with higher rates of unintended pregnancies and abortions than U.S. women as a whole.
He expressed hope that proposals for improving family planning for low-income women would be part of the overall conversation as policymakers tackle health care reform.
"Family planning should be noncontroversial," Sonfield said. "In this economic climate, it’s so important in terms of ability to get an education, to stay in the work force."
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