Funding cuts threaten family planning source
Is your clinic seeing more women without insurance coverage whose care is now funded by Medicaid? New statistics from the New York City-based Alan Guttmacher Institute (AGI) confirm your observations: Researchers estimate that in 2003, one in five women of reproductive age were uninsured, which signals a 10% increase since 2001. About 400,000 more women joined the ranks of those needing publicly subsidized care in that same two-year span.1
Increased needs are not translating into increased dollars, however; Medicaid cost-cutting proposals are under way in Congress and state legislatures. The fiscal year 2006 budget submitted in February by the Bush Administration includes changes to the Medicaid program that could effectively result in $45 billion-$60 billion in cuts to the program over the next 10 years.2 These proposed cuts represent a major challenge to family planning services, says Rachel Benson Gold, AGI’s director of policy analysis.
Half of all women who are at risk for unintended pregnancy if they do not use birth control need publicly funded family planning services, says Gold. With proposed funding cuts on the federal and state levels, the potential for a "perfect storm" is brewing that could make it harder for women to get the family planning services they need to help them plan their pregnancies and protect their health, Gold observes.
Senate supporters were able to turn back proposed Medicaid cuts in a March 17 vote. By a vote of 52-48, senators moved to stop the reductions and in their place establish a commission to explore policy changes to slow the program’s growth.3 However, expect further deliberations as Congress moves toward a final budget.
"I don’t think the question of Medicaid is going to be solved quickly and easily," says Gold.
Check your coverage
States cover a broad package of preventive care under Medicaid guidelines. Forty-seven states and the District of Columbia (DC) include their major prescription contraceptive methods under Medicaid; 32 states and DC cover over-the-counter methods such as condoms. Many states also cover testing and treatment of sexually transmitted diseases as part of their Medicaid-funded family planning programs.4
According to AGI research, 27 states and the District of Columbia have seen family planning funding decline or stagnate since 1994.5
The proposed cuts to Medicaid come even as evidence mounts that it can be used to improve access to contraception and reduce health care costs, says Gold. Nationally, each dollar spent to provide publicly funded family planning services saves $3 in expenditures for pregnancy-related and newborn care just to the Medicaid program alone.6
A national evaluation of Medicaid family planning waivers was performed by CNA Corp. in Alexandria, VA, with research assistance from Atlanta-based Emory University and the University of Alabama at Birmingham.7 It showed that such programs result in significant savings to the federal and state governments.
Such cost-saving documentation should garner support for the program; however, it does not, says Judith DeSarno, president and chief executive officer of the Washington, DC-based National Family Planning and Reproductive Health Association.
"Unfortunately, these well-established facts are ignored, and instead, family planning services and women facing unintended pregnancy are included in this administration’s rhetoric of optional services’ and optional populations,’" she states.
References
- Alan Guttmacher Institute. Critical Role of Medicaid in Financing Family Planning Services — State-Level Data. New York City; March 1, 2005. Accessed at www.guttmacher.org/pubs/2005/03/01/memo030105.pdf.
- National Family Planning and Reproductive Health Association. Medicaid Vote Too Close To Call — Please Call Today. Washington, DC; March 15, 2005.
- Weisman J. Senate rejects GOP budget cuts. Washington Post, March 18, 2005: A04.
- Alan Guttmacher Institute. Medicaid: A Vital Source of Support for Family Planning Services. New York City; March 2003.
- Sonfield A, Gold RB. Conservatives’ agenda threatens public funding for family planning. Guttmacher Report Pub Policy 2005; 4-7.
- Issue Brief: Medicaid: A Critical Source of Support for Family Planning in the United States. Menlo Park, CA; April 2004.
- Edwards J, Bronstein J, Adams K. Evaluation of Medicaid Family Planning Demonstrations. Alexandria, VA: The CNA Corp.; 2003.
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