One of the throwaway lines Republicans are using to justify taking health care away from millions of women by defunding Planned Parenthood is that community health centers are going to be there to take up the slack. Sara Rosenbaum, a public health expert,
debunks that one at the
Health Affairs blog.
Community health center patients are deeply impoverished—over 90 percent have incomes below twice the federal poverty level, and and even with the Affordable Care Act’s insurance expansions a large proportion remain uninsured, especially in the Medicaid non-expansion states. Thus, it is likely that these women obtain care at other publicly supported programs, including clinics operated by Planned Parenthood affiliates.
It is important to set the record straight about what it would mean to women were health centers suddenly to have to respond to a hole in care of this magnitude, especially given absurd claims about their financial ability to do so, such as assertions that community health centers could do so for $1.67 per patient. Community health centers are extremely efficient, but the cost of caring for their patients averages about $600 per person annually.
There are three primary reasons, Rosenbaum adds, that community health centers can't possibly absorb the millions of additional patients that would result from a 40 percent reduction in Planned Parenthood's operations funding if the $500 million from the federal government went away. First, "for every patient served by a community health center today, nearly three residents of low-income communities remain without access to primary health care." There's more need than these clinics can answer, and that's with Planned Parenthood clinics in the mix. Here's the other big problem for PP patients—community health centers are required by federal law to be in underserved areas, meaning there isn't going to be one around the corner from the PP clinic they're used to going to.
Second, the sudden cut-off of funding would create an immediate crisis community health centers would likely not be able to respond to, even where they might be available. Texas's decision to cut PP out of the state's family planning program a few years ago is an example: "non-Planned Parenthood clinics were faced with having to increase their women’s health service capacity by 81 percent on average simply to overcome the loss of Planned Parenthood services." That meant in reality that lots of women just lost their health care. The "state experienced a 9 percent decrease in program enrollees, a 26 percent decrease in Medicaid claims and a 54 percent decline in contraceptive claims, all of which illustrate the serious drop-off in utilization that occurred." That's not a reflection of a lack of need of health care, but a lack of access.
Finally, community health centers do provide women's health services, but that's not all they're taxed with doing. They have a full slate of primary care services they have to provide, and they are often "the only source of mental health care, dental care, and treatment for patients with serious and chronic health conditions such as hypertension, cardiovascular disease, and diabetes." There already aren't enough of them to meet the need that exists—adding more patients just isn't going to work.
None of this will convince a Republican hell-bent on destroying Planned Parenthood that it's a really bad idea and will only end up in more STD infections, more unintended pregnancies, more abortions and more undetected and untreated diseases. It won't matter to them because it's all happening to a population that doesn't exist for Republicans, anyway—poor people. But any Democrat who thinks that maybe they should be willing to make a deal and cut Planned Parenthood funding needs to know what they would be responsible for doing.