Kinsey Hasstedt - Guttmacher Institute
In recent months, social conservatives have doubled down on various long-standing proposals to deny public funding to Planned Parenthood and other providers focused on reproductive health. This includes efforts by Congress and the Trump administration to bar Planned Parenthood from receiving funding through federal programs—including Medicaid and the Title X national family planning program—as well as attempts to eliminate or reshape Title X, based on the premise that the program indirectly subsidizes abortion. Proponents of such restrictions are ultimately seeking to make abortion inaccessible for U.S. women, and so are seeking to shutter Planned Parenthood health centers and any safety-net health center providing publicly funded family planning services that additionally offers abortions (using other funds), or is affiliated with an abortion provider.
However, the consequences of these proposals reach far beyond abortion. Nationwide, Planned Parenthood health centers serve two million (32%) of the 6.2 million women who obtain contraceptive care from some type of safety-net family planning center.1 And 1.6 million (41%) of the 3.8 million contraceptive clients served by Title X–funded providers are served at Planned Parenthood health centers.
Recent analyses conducted by the Guttmacher Institute have looked at the impact of four different scenarios that align with many of the specific antiabortion policy attacks that have been proposed at the federal and state levels. Each scenario would radically undermine the nation’s family planning safety net and blatantly jeopardize women’s access to family planning care.
Scenario 1: Exclude Planned Parenthood from all publicly funded programs. For many years, social conservatives have sought to exclude Planned Parenthood health centers from receiving any type of public funding—whether in the form of grants specifically for the provision of reduced-cost or free family planning and other services, as under the Title X program, or in the form of reimbursement for services provided, as through Medicaid. President Trump’s fiscal year 2018 budget proposal takes this broad approach, cutting Planned Parenthood off from all federal programs—including Title X, Medicaid and many others—that its health centers rely upon to deliver affordable health care services. In this scenario, women who currently depend on Planned Parenthood would be left to seek care elsewhere.
Guttmacher’s analysis shows that if all other types of safety-net family planning centers had to fill the gap by serving all those currently obtaining contraceptive services from Planned Parenthood, women would find it considerably more difficult to obtain care. This is unsurprising, since Planned Parenthood serves two million contraceptive clients each year nationwide, and the average Planned Parenthood health center serves far more contraceptive clients than all other types of safety-net health centers.1
In order to serve all the women currently obtaining contraceptive services at Planned Parenthood health centers nationwide, other types of safety-net family planning providers would have to increase their client caseloads by 47%, on average.2 Federally qualified health center (FQHC) sites offering contraceptive care, hospital sites and others would have to increase their capacity by more than half (see chart 1).2 Sites operated by public health departments nationwide would have to increase their contraceptive client caseloads by a lesser proportion. Nevertheless, they still would have to take on hundreds of thousands of additional clients. Health departments have long been under-resourced and are often already stretched thin when it comes to maintaining the public funding and capacity necessary to meet the needs of their communities.
Across the country, eliminating Planned Parenthood would affect different types of safety-net family planning providers to varying degrees, depending on the make-up of a given state’s safety net. In 33 states, other providers would have to increase their contraceptive client caseloads by at least 20%, and in some cases, would have to at least double or triple their capacity.2
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