I was a Planned Parenthood affiliate chief executive, supervising a network of clinics in New York state, during the early days of this terrible recession. We ran deficits, cut hours, closed centers and laid off staff members. In a recession, things get very difficult — more and more people are in need, while government funds lag and donations dwindle. But still we did not turn patients away, even if they could not pay. At the same time, we had to fight political battles to preserve women’s rights to basic care and information about their sexual health. Those battles continue: Thursday, the House voted to defund Planned Parenthood permanently; the Senate opposed that measure. Amid the debate, let’s address some of the misperceptions about this nearly 100-year-old health-care organization.
Opponents of Planned Parenthood insist that giving the organization federal dollars allows it to spend other money in its budget to provide abortions. That is not possible — there is no other money.
Title X is a federal grant program that exists solely to help low-income and uninsured people access contraceptives and sexual health care; 5.2 million people use the program annually. But Congress has never appropriated enough money to take care of the estimated 17 million Americans who need publicly funded family-planning care. There always are more patients than subsidies.
Further, a Title X grant is designed to help with costs, not to fully cover them. So family-planning programs are required to find other money to support the Title X project — not the other way around. For patients who qualify for Medicaid, reimbursement rates for reproductive health services are lower than the cost of the care. A typical family-planning visit might cost upward of $200, including the exam, lab tests and contraceptive method, but the Medicaid reimbursement rate may be as low as $20.
That is what Sen. Jon Kyl (R-Ariz.) said this month in a speech against federal support for Planned Parenthood; his staff later said his assertion was “not intended to be a factual statement.”
Here is a factual statement: Planned Parenthood’s abortion care represents 3 percent of its medical services — 332,000 terminations out of a total of 11.4 million services provided in 2009. Nearly all the care offered at Planned Parenthood health centers is preventive services and screenings, including contraception, testing for sexually transmitted infections, pap smears and breast exams. Title X funds cannot be used for abortion care at any time, for any reason. Federal Medicaid funds can be used to reimburse a provider for an abortion when the pregnancy would endanger the life of the woman or resulted from rape or incest.
States can use their local tax dollars to support abortion care for low-income women, and 17 states do so under Medicaid. The capital city did, too — until last week, when Congress overturned the District’s Medicaid abortion coverage.
Contraception prevents the need for abortions, but most politicians who oppose abortion do not support birth control, either. Rep. Mike Pence (R-Ind.), the chief House sponsor of a bill to bar abortion providers such as Planned Parenthood from Title X, has praised a few elements of the program: pregnancy tests, breast cancer screening and HIV testing. He never mentions Title X’s essential work for 41 years — to provide information about and access to birth control, which 99 percent of Americans will use in their lifetime.
Women spend about five years either being pregnant or trying to get pregnant, and about 30 years trying not to get pregnant; the Guttmacher Institute estimates that half of the country’s unintended pregnancies end in abortion. If Pence wants to prevent abortions, he should lead the charge to triple Title X funding.
Instead, Pence has voted to eliminate Title X, and he has no answer for where the 5.2 million people served by that program would get care. Planned Parenthood centers offer contraception to nearly 2.5 million patients a year and serves 36 percent of all Title X patients.
Barring Planned Parenthood from participating in federal programs would lead to less access to birth control, more unintended pregnancies and more abortions.
I’ve never had a chance to talk to Glenn Beck, who implied recently on his Fox radio show that only “hookers” use Planned Parenthood.But when I worked for the organization, I would ask our supporters to picture this: You’re a 22-year-old woman with a job you don’t love, a toddler you’d die for and no health insurance. You live paycheck to paycheck, and you always know to the penny how much cash you’ve got until the end of the month. You’re rushing home on Route 9 to relieve your mom, who’s with the kid, and the engine light on the car comes on. You feel a wave of panic. You know you’re always one emergency away from everything falling apart. That’s our patient — I always have her in my mind.
Inside the Beltway, it is easy to forget that millions live on that edge. Our typical patient is a working woman between 20 and 24, maybe in school, often with children. But our centers nationwide see women and men of all ages, races, income levels, and marital and social statuses. The number of men seen in Title X-funded centers has tripled in the past 10 years, and the fastest-growing group of women served by Title X is those over 44.
Three million patients each year visit Planned Parenthood’s more than 800 health centers in every state, in big cities and small towns. In some areas, Planned Parenthood and the Title X-funded system are the only sexual health providers for hundreds of miles.
We screen people for high blood pressure, anemia and diabetes; we counsel them about smoking cessation and obesity; we connect them to other primary-care providers and social services. The huge response to the attack on family planning and on Planned Parenthood — hundreds of thousands of Americans signing petitions, showing up at rallies, calling Congress – is extraordinary. But it doesn’t surprise me. One in five American women has gone to Planned Parenthood at some point in her life, for respectful, compassionate, quality care. And now those Americans are going to have our back.
Clare Coleman is the president and chief executive officer of the National Family Planning and Reproductive Health Association. She headed a Planned Parenthood network in New York’s Hudson Valley, and worked in the U.S. House and as a lobbyist for Planned Parenthood.
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