It is imperative we continue to provide Federal funding to Planned Parenthood.
Before we talk about that, however, let’s get a better understanding of how funds are provided to Planned Parenthood (PP) and how these funds are spent.
According to NPR, in 2014 PP received $528 million in Federal funding from two sources—Title X and Medicaid. Title X Population Research and Voluntary Family Planning Programs of the Public Health Service Act was enacted in 1970. It provides funding for a variety of medical services including cancer screening, HIV testing, pregnancy testing, and birth control. Title X specifically prohibits funds from being used for abortion services. Only 25% of the Federal funding PP receives comes from Title X funds.
The remaining 75% of Federal funding comes from Medicaid. Medicaid is a joint program between the individual State and Federal governments. Essentially, the State administers the program, determining who is eligible and providing those individuals with an insurance plan. The Federal government sets some of the rules but leaves much to the discretion of the State. The Feds also reimburse the State for 90% of all the care provided and the remaining 10% is State responsibility.
In 1977, Congress passed the Hyde Amendment to the Medicaid law. This law allows for the use of Federal Medicaid funds for abortion in very specific, very limited cases—rape, incest, and where the mother’s life is threatened. Some states allow Medicaid reimbursement for abortion for other definitions of medical necessity. In these cases where the complication meets the State definition but not the Federal one, the State is responsible for 100% of the cost.
Combined, Medicaid and Title X funding accounts for nearly 41% of its total $1.3 billion budget. The remainder comes for private, non-government, and other sources.
The majority of care (76%) provided by PP is STD/STI screening and treatment (42%) and contraception (34%). They also provide other women’s services like pregnancy testing and prenatal care (11%), cancer screening (9%), abortion (3%), and other services like adoption referrals and family practice services (1%).
Let’s talk about facts, baby.
According to Guttmacher.org, the need for publicly funded contraceptive services has risen steadily through its 2013 update, when 20.1 million US women required them. (Note: their definition of this group: “sexually active, physically able to conceive and not currently pregnant or trying to get pregnant, and were either adults with an income under 250% of the federal poverty level or were younger than 20.”)
Of this group, 28%—that’s 5.6 million women—were without any insurance. The report further states that this increase is driven entirely by an increase the proportion of adult women who fall beneath 250% of the poverty line. The overall number of women of child-bearing age remained stable and the number of teens in need of service decreased.
PP is designed to be a “safety net” for those these women, for those who otherwise could not afford care. Publicly funded providers—PP is one but there are others as well—provided services to 42% of these women. 79% of people served by PP in 2014 were at or below 150% of the Federal poverty level, which was $11,670 for a single adult. People are at or exceed 138% of the poverty line ($16,105 for a single adult) are ineligible for Medicaid.
Let’s say I’m a single woman working for Walmart as a cashier, living as I do in Yuma, Arizona. Walmart is notorious for refusing to give their employees benefits by limiting their hours so they are considered part-time employees. According to PayScale.com, the salary range for cashiers is $8.11 to $11.87 per hour. Taking the average salary of $9.99 per hour, this equates to $15,584 per year, assuming an average of 30 hours per week and that I never call in sick, take a vacation, or miss work for any reason.
For 2017, the Federal poverty line is $11,880, meaning the Medicaid line is $16,394. This means that anyone making more than $10.50 per hour and working 30 hours per week under the same circumstances as above will not qualify for Medicaid.
Also, note that Medicaid has a finite budget. For example, one of my coworkers has three children. Recently divorced, she is not receiving child support from her former husband. Her children are all on a Medicaid plan, but she is not. She does not qualify for a plan, as children are prioritized over adults and there is simply not enough money to cover everyone.
Another friend found herself in a contract job without medical benefits and with an unintended pregnancy. She didn’t qualify for Medicaid either, though the child would, after birth. She received all of her prenatal care from PP and has a healthy, and adorable, baby boy. Without PP, she would have received no prenatal care at all.
These women—and men; PP does not discriminate based on gender and services are provided to men as well as women—are exactly why PP is necessary. PP provided services to 2.7 million people in 2013.
$528 million sounds like a great deal of money, and it is. However, it represents 0.015% of the total Federal budget. It also means PP spent less than $200 per patient and a mere $80 was Federal money. I consider that a pretty good use of my tax dollars.
Decreased funding, increased burden
Recall that 42% of services provided by PP are to diagnose and treat STI/STDs. Now, take PP out of the equation. Where do you think all these people are going to go?
The emergency room, of course. And if you’ve been to the ER lately, you know they are already stretched to the limits of what they can reasonably do.
In 2011, there were 125.7 million ER visits, according to CDC data. Of those, 13.8 million were for a gynecological examination. The approximate average cost of that visit is $665. (I based this on the cost of UTI visit in the ER as I could not find a specific cost for STI screening.) At the Phoenix PP, the standard rate (without any discounts) is $142, a savings of $523. Extrapolated, this means that the healthcare system saves $593 million dollars because the 1.134 million people who would otherwise visit the ER for STI screening visit PP instead.
And who would be paying for that $523 per patient difference? You and I, in the form of higher healthcare costs and premiums. Why? Because the people who use the emergency room for these services generally can’t afford them. These are the people without insurance who have no other access to healthcare. They can’t afford a visit to their local family physician, so they go to the ER, because they know they cannot be turned away based on ability to pay.
What you may NOT know is that much of the costs of this care is written off by hospitals as what is termed “charity” or “compassionate” care. In 2010, hospitals provided $39.3 billion in charity care. This drives up the overall cost of medical care and the cost of insurance.
I know, I know. PP provides abortions and therefore must be stopped at all costs.
Look, I understand you have a personal/religious/moral objection to abortion. I get it. I have one, too. However, my right to exercise my objection ends where your healthcare begins. I have no more right to tell you that you CAN’T have an abortion than you have to tell me I MUST have one.
Besides, the whole point of PP is to PREVENT unintended pregnancies. Remember, 34% of the services they provide are contraceptive. Here’s what’s really important from the Guttmacher report: publicly funded entities like PP prevented two million unintended pregnancies in 2013. Of those, 693,000 would have resulted in abortion, making the rate of abortion a whopping 60% higher.
Simply put, removing funding to PP would result in more abortions. Is it really what anyone wants?
Photo credit: Pixabay