When a federal judge ruled in August that Texas can withhold millions of dollars from Planned Parenthood and other family planning clinics, Gov. Rick Perry proclaimed it a "win for Texas women." As it turns out, Perry's crusade against Planned Parenthood isn't a win for either the women of Texas or the budget of the Lone Star State. Just as experts predicted, each dollar saved in family planning spending will result in almost four dollars in new costs to care for thousands of new mothers and children the budget axe will produce.
As the New York Times explained last week, "When state lawmakers passed a two-year budget in 2011 that moved $73 million from family planning services to other programs, the goal was largely political: halt the flow of taxpayer dollars to Planned Parenthood clinics." Now, Texas Republicans are coming to grips with a looming budget boomerang:
The latest Health and Human Services Commission projections being circulated among Texas lawmakers indicate that during the 2014-15 biennium, poor women will deliver an estimated 23,760 more babies than they would have, as a result of their reduced access to state-subsidized birth control. The additional cost to taxpayers is expected to be as much as $273 million -- $103 million to $108 million to the state's general revenue budget alone -- and the bulk of it is the cost of caring for those infants under Medicaid.As Rick Perry might say, "Oops."
Ahead of the next legislative session, during which lawmakers will grapple with an existing Medicaid financing shortfall, a bipartisan coalition is considering ways to restore some or all of those family planning dollars, as a cost-saving initiative if nothing else.
Austin Democratic Rep. Donna Howard was being kind to her Republican colleagues when she lamented, "I know some of my colleagues felt like in retrospect they did not fully grasp the implications of what was done last session." Republican Sen. Bob Deuell, one of the leaders in cutting off funding to Planned Parenthood, acknowledged while "it's not the government's role to provide family planning...you have to look at what happens if we don't."
Of course, Texas Republicans can't say they weren't warned.
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As part of their perpetual war against Planned Parenthood, Republican leaders in Washington last year began proposing to "zero out" federal funding for the Title X family planning program. If the likes of Denny Rehberg (R-MT) get their way, Congress would eliminate the $317 million for Title X, a program signed into law in 1970 by Richard Nixon, who proclaimed that "no American woman should be denied access to family planning assistance because of her economic condition." Writing at the Huffington Post, Laura Bassett documented the boomerang effect this Republicans' faith-based cutting would have on the nation's bottom line:
The cost of covering a Medicaid-funded birth, including prenatal care, delivery, postpartum and infant care for a year, was an estimated $12,613 in 2008, according to a May 2010 Guttmacher Institute study. This far outpaces the cost of providing birth control and other contraceptive services to low-income women at Title X-funded clinics, which averages only $257 per client per year.As Ruth Marcus pointed out in February, "Every public dollar invested in family planning care saves $3.74 in Medicaid expenditures for pregnant women and their babies during the first year of care. Imagine the lifetime savings."
Crunching the numbers, every dollar the U.S. government spends on family planning services to help people plan how many children to have and when to have them saves taxpayers about $3.74 in Medicaid birth-related costs. The government spends about $300 million a year on the Title X program, but in 2008 alone, it saved the country $3.4 billion dollars in return.
Title X clinics serve more than 5 million women annually, the vast majority of them low-income."And then," Marcus noted, "there is the other 'important work'...2.2 million Pap smears, 2.3 million breast exams, nearly 6 million tests for sexually transmitted infections."
The Guttmacher Institute has estimated that Title X helps prevent nearly 1 million unintended pregnancies annually. The institute says these pregnancies would otherwise result in 433,000 unintended births and 406,000 abortions.
Of course, the Republican crusade to take the knife to women's health care isn't about budgets but ideology. As Texas Rep. Wayne Christian described the battle in the Lone Star State, "Well of course this is a war on birth control and abortions and everything, that's what family planning is supposed to be about." Apparently, that's the same tortured logic Gov. Perry used in announcing his intent to replace Planned Parenthood with "crisis pregnancy centers" that don't provide health services. As he put it in signing draconian anti-abortion legislation this week:
"To be clear, my goal, and the goal of many of those joining me here today, is to make abortion, at any stage, a thing of the past."Whether or not Texas, with its 46th ranked health care system and fourth highest teen birth rate in the nation, makes abortion a thing of the past, tens of thousands of new babies and hundreds of millions of dollars in new taxpayer spending are in its future.