We know what happens when Planned Parenthood clinics close. Back in 2011, the Texas legislature slashed family planning funds by 66 percent, closing 82 family planning clinics, one-third of them associated with Planned Parenthood. The legislature also passed a law to make it impossible for Texas Planned Parenthood affiliates to participate in the Medicaid waiver program.
Boy, did things change. Reported in an August 2016 Guardian article, “The rate of Texas women who died from complications related to pregnancy doubled from 2010 to 2014 …an estimated maternal mortality rate that is unmatched in any other state and the rest of the developed world.”
As the U.S. House and Senate — both in Republican hands — move to strike Planned Parenthood from receiving Medicaid reimbursements nationwide, Texas is instructive for what that might mean for women, children, and families across America.
Services to half as many women
The results cited above were found in this past September’s issue of “Obstetrics & Gynecology.” Other results showed that Texas clinics not closed had trouble providing services to make up for those lost to closure. The upshot was that services, “such as low-cost or free birth control, cancer screenings and well-woman exams” were provided “to only half as many women as before.”
That so many of the 130,000-plus women previously served by Planned Parenthood in Texas could not access care was not important to legislators. They seemingly had no qualms about sacrificing the lives of pregnant Texas women on their altar of rightwing ideology. In fact, their breezy dismissal that women could just go get their services at clinics other than Planned Parenthood appears to be the Texas version of “let them eat cake.”
Health gains in Calif., Colo.
It is important to note that California, not hostile to Planned Parenthood or reproductive health care, has cut its maternal death rate by almost two-thirds in the past decade. And Colorado did a pilot study of offering free long-acting birth control to poor women and teenagers. After four years it showed “a 42 per cent drop in abortions, a 40 per cent drop in unintended pregnancies, and a savings range of $49 to $111 million in birth-related Medicaid costs.”
Then again, there’s, Indiana — home of former governor, now vice-President-elect Mike Pence — which implemented public health spending cuts causing Scott County’s only Planned Parenthood clinic to close in 2013. That facility served as the county’s only HIV testing center. With no testing available, an HIV outbreak ensued that reached almost 200 cases before it was controlled.
The truth is, more than half of Planned Parenthood health centers are in rural or medically underserved communities. And in 21 percent of counties with Planned Parenthood facilities, Planned Parenthood is the only “safety-net” family planning provider. That simply means a great percentage of Planned Parenthood patients are either uninsured or reliant on Medicaid. The notion that private groups and Community Health Centers (CHCs) are clamoring to serve that population and will step in the minute Planned Parenthood goes away is ideology-driven magical thinking. A 2013 national study out of George Washington University of CHCs showed that 69 percent reported referring their patients to family planning providers like Planned Parenthood.
The needs are great
Poor and rural patients need family planning services and affordable birth control; they need pregnancy tests and prenatal services; they need breast exams, cancer screenings, and pap smears; they need testing and treatment for sexually transmitted infections; and they need education. Patients love Planned Parenthood because they get all that in a professional setting where they are treated with dignity and respect.
What played out in Texas was a political vendetta over abortion rights; it had nothing to do with Medicaid reimbursements. But it certainly makes clear what will happen if that vendetta goes national.
A writer and columnist from Fargo, N.D., Jane Ahlin also has taught English at Minnesota State University Moorhead. She currently serves on the board of Planned Parenthood of Minnesota, North Dakota, South Dakota.
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