Emilie C. Ailts: Preventive reproductive health care pays off
April 14, 2009
This year is the 55th birthday of the birth control pill. It is also 44 years since the U.S. Supreme Court decriminalized birth control in Griswold v. Connecticut. Yet, debates over family planning and contraception are alive and widespread.
Coloradans witnessed this first hand last fall when the “personhood” amendment that could have re-criminalized birth control in the state was defeated. Similar measures have already been introduced in seven other states so far this year.
However, current health policy discussions about the role of publicly funded preventive reproductive health care services demonstrate a great step forward in accepting that health care includes family planning. In fact, debates over the availability of affordable birth control, sex education and the financial wherewithal to acquire said resources, are moot without considering the critical role government can play to empower individuals to make responsible reproductive health decisions.
This includes the support of publicly funded family planning programs like Title X and the Medicaid family planning waiver. According to a recent report by the Guttmacher Institute, 2 million unintended pregnancies and 810,000 abortions nationwide are prevented annually by publicly funded family planning services. In Colorado, publicly funded family planning centers are estimated to have saved more than $69 million in 2004 alone and, in 2006, prevented 28,500 unintended pregnancies and 11,900 abortions. These numbers demonstrate the value of publicly funded, equitable resources that enable families of all socio-economic backgrounds to acquire the means for a secure livelihood.
Further, the current economic downturn puts a significant strain on state resources. For Colorado, where state taxpayer dollars cover prenatal, delivery, and infant-care expenses for an estimated 28,000 births every year, the Guttmacher report states an easy path to minimize health care expenditures covered by the state is to invest in preventive reproductive health care.
Last year, Gov. Bill Ritter signed into law a bill that removed a statutorily imposed income-eligibility cap for preventive family planning services provided through the state’s Medicaid program. The law authorizes the Colorado Department of Health Care Policy and Financing (HCPF) to determine an appropriate income-eligibility limit indexed to the federal poverty level that demonstrates budget neutrality. HCPF must submit a waiver to the federal Centers for Medicare and Medicaid Services for this change to go into effect. If approved, the waiver will enable Coloradans who don’t have health insurance and who otherwise would not qualify for full Medicaid benefits to be eligible for preventive reproductive health care services.
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Colorado joined the ranks of more than 25 other states that are working to expand their publicly funded family planning programs to ensure affordable access to critical services that not only yield significant cost savings, but also have a tremendous impact on reducing unintended pregnancy, the need for abortion, and the spread of dangerous diseases. Research verifies that $4 are saved for $1 invested in preventive reproductive health care services, from birth control counseling, distribution of contraceptive drugs and devices, and screenings for sexually transmitted infections. And Colorado pays just 10 cents of every $1 spent on these preventive family planning services, unlike other health care services covered by Medicaid.
As of 2008, 26 states had obtained federal approval to extend eligibility for Medicaid family planning services to individuals who would otherwise not be eligible; 20 states extend benefits under an income-eligibility formula similar to that pursued by Colorado. These states have demonstrated that expanded family planning services have dramatically reduced overall state and federal spending because of a decrease in Medicaid expenditures for prenatal, delivery, and infant care coverage.
More than 270,000 Colorado women and girls aged 13 to 44 needed publicly funded birth control services and supplies in 2006. This number will only rise as private insurance rates increase and Coloradans who have been laid off lose their health care benefits. Colorado already has taken steps to maximize the opportunities for savings, but given the current climate, we can and must do better.
By working in collaboration with medical experts, community-based organizations, and reproductive health care advocates, Colorado policymakers can develop common-sense strategies that ensure preventive family planning services are considered core health insurance benefits and essential components in comprehensive health care reform. As a result, Coloradans can realize both tremendous cost savings related to reproductive health care, and healthier families and communities.
Emilie C. Ailts is executive director of Denver-based NARAL Pro-Choice Colorado.