March 2, 2011
Family Planning Cuts in the Budget Proposal
UPDATE: The repeal of Contraceptive Equity was removed from the budget.
The Governor’s budget would result in the Elimination of Contraceptive Equity: “The Governor recommends eliminating the requirement that health insurance policies provide coverage for contraceptives prescribed by a health care provider and outpatient medical services related to contraceptives.”
Contraceptives are the most widely used prescription drugs by women of reproductive age, and over 90% of women use at least one kind of contraceptive method during their lifetime. Women pay 68% more than men do in out-of-pocket health care costs, and much of these costs are for reproductive health care, including prescription contraceptives. Costs for supplies alone can run approximately $360 per year for oral contraceptives; $180 per year for Depo-Provera; $450 for Norplant; and $240 for an IUD. While these costs can be prohibitive for women, covering birth control actually results in cost savings for employers. The National Business Group on Health, an organization representing over 160 large national and multi-national employers, has estimated that failing to provide contraceptive coverage actually costs employers 15-17% more than providing the coverage (Promoting Healthy Pregnancies: Counseling and Contraception as the First Step; Family Health in Brief, 2000).
Because only women use prescription birth control, excluding birth control coverage under prescription drug plans singles out women. Historically, it has taken state laws to ensure that health insurance plans cover women’s health issues. Advocates have secured insurance mandates in WI that require coverage of maternity and newborn care; coverage of mammograms and breast reconstruction surgery; and direct access to obstetricians and gynecologists. On June 29, 2009 Governor Doyle signed the state budget, which included Contraceptive Equity. Contraceptive Equity went into effect in Wisconsin on January 1, 2010.
Walker’s budget threatens to repeal the progress made over the last year by again limiting women’s access to contraception. These threats extend far beyond reproductive freedom. Unintended pregnancy has been linked with numerous negative maternal and child health outcomes. Contraception also allows women to invest in higher education and participate more fully in the nation’s workforce, contributing more broadly to issues of gender equity. The Guttmacher Institute reports that the benefits of contraception for women and children are extensive and well-documented.
FAMILY PLANNING SERVICES FOR MEN
Walker’s budget also seeks to eliminate Medicaid payments for family planning services for men. As of May 2010, Wisconsin’s Family Planning Waiver allowed coverage of select family planning services–including family planning-related office visits, condoms, and testing and treatment of sexually transmitted infections–for males age 15-44 who have an income that is at or below 200 percent of the Federal Poverty Level (FPL).
This expansion of family planning services allowed men to take responsibility for preventing unintended pregnancy by providing them free access to contraceptives and information through family planning office visits. Furthermore, it allowed for improved sexual health by removing the cost barrier to STI testing and treatment. The de-funding of family planning services for men will result in more unintended pregnancies and transmission of STIs, negatively impacting both men and women.
STATE FAMILY PLANNING FUNDING
Federal Title V Maternal Child Health (MCH) Grants and state general purpose revenue together fund local public health departments and private organizations to provide family planning and reproductive health services in more than 50 counties. Together, these funds are pivotal to maintaining access to family planning services, including lifesaving cancer screenings, testing and treatment for sexually transmitted infections (STIs), patient education and counseling, pregnancy diagnosis, prenatal counseling, referrals and other health services. According to the Department of Health Services, women’s health programs that prevent unintended pregnancies save taxpayers about $140 million each year and prevent over 11,000 unintended pregnancies.
Walker’s Budget eliminates all state GPR funding for family planning – $1.9 million per year or $3.8 million over the biennium. Over 30,000 patients each year receive critical preventive health care at state funded family planning clinics in their communities. This cut will weaken the state family planning provider network by cutting a critical source of funding for local clinic operations. Eliminating this funding may force some clinics to close and will drastically limit women’s ability to access basic health care services, leading to more unintended pregnancies, later cancer diagnoses, and higher costs for Wisconsin taxpayers. These cuts would force the Wisconsin State Laboratory of Hygiene to stop offering cervical cancer screenings, HPV screenings and biopsies for uninsured women or require them to bill the family planning clinics, who would in turn bill their patients. The elimination of these state funds could also jeopardize $10 million in federal MCH block grant funding which supports programs designed to promote healthy birth outcomes, reduce infant mortality and provide health care and support for special needs children.