If you’re an average woman, you want two children, according to various surveys. That means you’ll spend about five years of your life trying to become pregnant, being pregnant or recovering from pregnancy, and 30 years trying to avoid it.
You can do that thanks to the June 1965 landmark Supreme Court decision Griswold v. Connecticut, which affirmed the right of married couples to use contraceptives — and more importantly, recognized an individual’s right to privacy in family planning matters. Universal usage and acceptance of contraceptives followed, transforming the lives of millions of Americans.
The Griswold case was a catalyst for our national family planning program — Title X of the Public Health Service Act — the only dedicated source of federal funding for family planning services. Created in 1970, Title X provides access to family planning for all, without regard to economic circumstances.
Today, contraceptives are an important part of family life in America, so much so that 98 percent of us have used birth control at some point in our lives, and we mostly take it for granted.
We shouldn’t. During the recent battle in Congress over funding the government, the House of Representatives voted to eliminate Title X. Opponents of family planning used a mixture of misinformation and innuendo to entangle family planning in their anti-abortion war, ignoring the fact that Title X saves the government some $3.4 billion every year by preventing unintended pregnancies, nearly half of which would likely have ended in abortion. The Senate saved the program, but another attempt to kill Title X is certain this year. When it comes, Americans must recognize that access to basic primary and preventive care is being threatened.
Title X funds 4,500 nonprofit- and government-run sites nationwide: most are county and local health departments. The rest are hospitals, family planning councils and other private nonprofit agencies. These agencies are required to provide preventive and primary health care services including pelvic exams and Pap tests; pregnancy testing; screening for high blood pressure, anemia, diabetes and cervical and breast cancer, and for sexually transmitted infections including HIV; basic infertility services; health education; and referrals for other health and social services — as well as contraceptives and counseling about them.
These are the facts of life: According to new Guttmacher Institute research, unintended pregnancy costs U.S. taxpayers approximately $11 billion a year. Without publicly-funded family planning services, these costs would be 60 percent higher. In 2008, services at Title X centers helped prevent 973,000 unintended pregnancies that would likely have resulted in 432,600 births and 406,200 abortions. The centers also performed 2.2 million Pap tests, 5.9 million STI tests and a million confidential HIV tests in 2009 alone.
Seventeen million people need some assistance in order to get this important care, but today, Title X is funded to cover just over 5 million of those in need. There are always more patients than subsidies. Seventy percent of the individuals seen at Title X-funded health centers have incomes at or below the federal poverty level — meaning they earn less than $10,830 per year. Many of them are working young adults, living paycheck to paycheck. They count down the days until they get paid and are just one unexpected problem from disaster — if the car engine light comes on; the childcare center raises its fees; or their hours are cut.
Six in 10 women who get care from Title X consider it their usual source of health care, and for many it is their only source. Patients under the federal poverty level receive services at no cost to them; those who make over $10,830 a year are provided services on a sliding fee scale according to income.
Although no patient is turned away because of an inability to pay, Title X actually saves money for the government. Every dollar invested in publicly-funded family planning averts nearly $4 in Medicaid costs. Given its proven effectiveness, it only makes sense that the Obama administration should include contraceptives in the women’s health preventive services benefit under the Affordable Care Act.
The Centers for Disease Control and Prevention has cited family planning as one of the 10 great public health achievements of the 20th century, and Title X funding is essential to our effort to prevent unintended pregnancies and improve public health while saving taxpayers billions of dollars a year.
As the states struggle with growing budget shortfalls, continued funding for Title X should be recognized for what it is: an essential part of America’s health care system.
Coleman is president and CEO of the National Family Planning & Reproductive Health Association.