Republicans on the House Appropriations Committee offered some promising phrases when describing their fiscal year 2018 Labor-HHS budget: “Invest in essential health,” “focus investments in programs our people need the most,” and “targeting investments in … public health.”
House LHHS Subcommittee Chair Tom Cole concluded, “This bill is one that reflects the priorities that Americans value, and will continue to support the well-being of Americans through funding these vital programs.”
Yet, the contents of the House proposal are in direct opposition to all of those promises.
The House plan would eliminate funding for Title X, denying preventive health services, including breast and cervical cancer detection, screening for sexually transmitted diseases, HIV testing, and contraception to more than four million low-income people every year.
This action contradicts guidance from Rep. Kristi Noem of South Dakota earlier this year to not “take a penny from women’s health…” during floor debate on H.J. Res. 43 to overturn a Title X rule.
It flies in the face of Rep. Jackie Walorski’s assurance that that same resolution “…won’t reduce funding for women’s health care.”
Here we are a few months later, facing this exact threat to the family planning safety net.
I’ve seen first-hand how crucial Title X is to our most-vulnerable residents, it serves as a real lifeline to patients who already face tremendous barriers. Six in 10 women seen in a Title X setting have reported that a Title X-supported health care center was their regular source of medical care, and four in 10 women said it was their only source of care.
There are systemic benefits, too. The unintended pregnancy rate is at a record low and the rate of teen pregnancy is at a 30-year low.
This bill being advanced would force many health centers across the country to shut their doors. If people cannot come to the publicly funded family planning provider they know and trust for confidential, high-quality care, they will go without that care. Women will be more vulnerable to STDs and at a greater risk of unintended pregnancy and poor birth outcomes. And, as a country, we will see a drastic reversal in those public health gains.
Unfortunately, the House budget isn’t the only threat to our country’s publicly funded family planning provider network. The Senate’s plan to repeal the Affordable Care Act would have slashed the Medicaid expansion that has afforded the opportunity to millions to have comprehensive health coverage and defunded Planned Parenthood, only worsening the blow to the family planning safety net and the patients it serves.
There are state-level threats, too. Texas has submitted a Medicaid waiver request to create a federally funded family planning program that discriminates against certain family planning providers. Since Texas gave up federal funding in 2013 to create a family planning program that excludes Planned Parenthood, the state has seen the closure of one quarter of all publicly funded family planning health centers, a 35% decline in women on Medicaid using the most effective methods of contraception, a 27% spike in births among women, and a three-fold increase in the state’s maternal mortality rate.
Similarly, Iowa discontinued its state-federal partnership for its Medicaid family planning program, replacing it with a state-funded program that bars funding from going to agencies that also provide abortion care. Subsequently, four health centers in Iowa closed, impacting thousands of patients across the state.
These actions – at both the federal and state level – are systematically crippling the family planning provider network despite growing demand for publicly funded care.
I agree with Rep. Cole – we must “continue support the well-being of Americans through funding these vital programs.” I hope Congress uses its actions, not just words, to demonstrate that it recognizes how important the family planning safety net is in ensuring access to quality health care services. The health and well-being of the millions of poor and low-income women and men depend on it.