Wisconsin’s Assault on Women and the Poor

This article by carafem’s Vice President, Melissa Grant, originally appeared on the Huffington Post Blog

Last Thursday, the Wisconsin State senate proposed two bills that will work to decrease resources for people of low-income to receive family planning services through Planned Parenthood. One bill reduces the amount of money that Planned Parenthood can collect for dispensing birth control. The other bill would prevent any organization that provides abortion care from participating in the federal Title X program.

In Wisconsin, this means the elimination of about $3 million worth of family planning services to Planned Parenthood clients, specifically limited to preventive healthcare, cancer screening, birth control, contraception and sexually transmitted disease testing and treatment. Both of these bills will strip funding from every organization that provides abortion care as part of its service mix.

Title X is the payer of last resort for family planning in the United States. Under this federal program, which originated during the Nixon Administration, organizations can apply for Title X grants to provide reduced cost annual exams, pap smears, pregnancy testing, contraception and STD testing to low-income clients. In 2012, Title X funded centers served approximately 4.7 million US clients, and a reported 40,580 clients in Wisconsin.

Supporters of these bills state that current funding can be redistributed to other providers of health care for low-income persons, like the state’s, “Well Woman Program,” or to other free or low-cost health clinics. However, this redistribution was not well thought out. Currently Wisconsin’s Well Woman Program only serves women ages 45-64, certainly a low percentage overall of the users of contraceptive services.

A call to some of the other state providers of comprehensive, low-cost health care found many are not currently accepting uninsured new clients for reproductive health care. How will the state accommodate over 40,000 former Planned Parenthood clients if the current health providers cannot see a new client for several weeks to even months? These organizations that provide full program medical care services (e.g., federally qualified health centers) are often so overworked with treating diabetes, heart disease, high blood pressure and other chronic disease that family planning becomes an afterthought. Either it is not delivered at all, or it becomes a very low priority. And that could affect us all.

Martha Plimpton said it perfectly in an article published by Slate a few years ago, when she stated, “it’s long been accepted as fact that the availability of family planning services saves lives. Where women have access to these services, children and families are healthier, and society at large benefits.”

Title X is a complicated federal program with very specific guidelines about who can receive funding and how much services can cost. Prior to the passage of these bills, many organizations chose not to participate in Title X programs because they paid so little and had so many requirements, from reporting to training to billing to audits. Organizations are hard pressed under Title X regulations to ‘break even’ financially, as very low-income people must be provided medical care for free, and the amount of Title X reimbursement per client often does not cover costs of providing the service.

Because it is a federal program, the US Department of Health and Human Services Office of Population Affairs (OPA) administers Title X funding. Clinics receiving Title X funding are audited rigorously by the OPA including regular comprehensive site visits. Regulations are very clear and Wisconsin runs a tight ship, so literally no money is being spent in any way on abortion care with funds that came from Title X. The feds assured this with rigid controls and audits. So, in essence there was no reason to pass these bills, other than to hurt Planned Parenthood and other abortion providers and ultimately the people who use this care.

What the media has failed to report in the news is that this is bigger than Planned Parenthood. Taking Title X funding from an organization like Planned Parenthood of Wisconsin that has efficiently and effectively provided high quality family planning services at a reduced cost for over 40 years will create a huge challenge for the remaining medical providers in the state. The state of Wisconsin will be hard-pressed to find other organizations that can take on the challenges associated with serving this number of clients while managing the requirements of the Title X program.

This may prove to be the most outrageous part of these bills. They will do nothing but prevent access to cancer screenings, birth control, and STD testing and treatments for the underprivileged. If anything, these bills may backfire and cause more unintended pregnancies and abortions, as low-income people suddenly have no place to go for these services.