A family planning program that serves nearly 140,000 low-income Georgia women each year has come under the budget ax in Washington, stirring the long-simmering debate about the costs and benefits of programs designed to prevent unplanned pregnancies.
Lawmakers who voted to eliminate funding for Title X of the Public Health Service Act of 1970, a federal reproductive health program, say that although the cuts may be regrettable, they are necessary if Congress is to stem the tide of federal red ink.
Advocates of family planning say the cutbacks would result in as many as 35,000 additional unplanned pregnancies annually in Georgia, raising the abortion rate and costing taxpayers much more in health and welfare programs.
“When you put up barriers to contraceptives, you inevitably increase the abortion rate,” said Emory University’s Carol Hogue, professor of epidemiology and a Terry professor of maternal and child health. She said she believes family planning programs are “under attack” — a charge rejected by Georgia lawmakers who voted in favor of the bill.
“This is not a direct attack on any specific program,” said Leslie Shedd, press secretary to Coweta County Republican Rep. Lynn Westmoreland.
“We are in a fiscal crisis in Washington and some very tough decisions have to be made in order to dig our way out of this mess,” Westmoreland said.
Title X provides contraceptive counseling, cancer and STD/HIV screenings, pre-natal care and sexual health education to at least 144,000 Georgians, of whom 139,000 are women, according to the Georgia Department of Community Health. Georgia receives $8.5 million annually, which is dispersed through roughly 250 of the state’s health departments, hospital clinics and community health centers, according to the state and the Guttmacher Institute, a nonprofit that produces research and policy analysis on reproductive health.
The state is required to match 10 percent of the federal funds; it now overmatches that requirement with $977,000, said Brain Castrucci, director of the state’s Maternal and Child Health Program. If the federal money disappears, the state could decide to reallocate that sum to other programs, he said.
The Title X changes were among $60 billion in budget cuts included in the 2011 appropriations bill passed last month by the Republican-controlled House. Nothing resembling that bill is expected to pass the Democrat-controlled Senate. However, with a majority of Americans demanding reductions in federal spending, all discretionary programs, including family planning, are virtually certain to remain targets for budget cutters.
In a much publicized amendment, House Republicans also voted to prohibit federal funds to Planned Parenthood and its affiliate organizations, arguing that tax dollars shouldn’t be given to organizations that provide abortions among their services. One Georgia office of Planned Parenthood, in downtown Atlanta, receives Title X funds, said Leola Reis, Planned Parenthood of Georgia spokeswoman. Those funds are a small fraction of the Title X money distributed to hundreds of organizations throughout the state.
Rep. Hank Johnson, a Democrat from Lithonia, said eliminating Title X is misguided, if Republicans’ true goal is to eliminate abortion.
“Studies have shown that in the absence of Title X, we are going to see the level of abortion in Georgia increase by about 44 percent,” he said. “That is certainly ironic, because those who seek to defund Planned Parenthood and Title X are the same people who would deny a woman the right to an abortion.”
Ninety-eight percent of Georgians receiving Title X-funded care are working poor, unemployed or have no health insurance, according to the state health department. GDCH estimates that for every dollar spent on family planning services, $4.40 is saved on medical care, welfare and nutritional programs for infants and toddlers.
Hogue, the Emory professor, also noted that Title X was created under President Richard Nixon and supported by the first President Bush.
“People understood 40 years ago things they have forgotten since, which is that poor women need to have help in order to avoid pregnancies they do not want. And if they have those pregnancies, those have additional costs to society,” she said.
Jerry Luquire, head of the Georgia Christian Coalition, said he sees no need for family planning programs.
“Take a stroll through any planning aisle in any drugstore and you will find out everything you need to know,” he said. “If they know how to have sex, they know how to prevent pregnancy.”
But without Title X, many women might no longer be able to afford the tools to prevent pregnancy or have regular health screenings, Planned Parenthood’s Reis said.
“We are concerned about women who are already struggling to pay for birth control and could put off other tests,” she said. “We could see more undiagnosed cervical cancers.”
Rep. Paul Broun, an Athens Republican who was a practicing physician for about 40 years, said the solution is health care reform that would spur private providers to offer care at lower prices to needy patients.
“There are a lot of free clinics, and a lot of good doctors who volunteer their time and services at those clinics. Also, many individual physicians, if the federal government didn’t bar them from doing so, would give reduced [priced] care to their lower-income patients,” he said. “We’re in a national financial crisis today largely because people developed the notion that the federal government should do everything for everybody.”
About the Author
