Last week, the Congress summarily excised a provision from the stimulus package that would have expanded family planning services for low-income women, claiming that the provision didn't belong in an economic recovery package. Led by Republican Congressman John Boehner, the provision was mischaracterized as costing the taxpayers money (though the nonpartisan Congressional Budget Office determined that it actually saves the taxpayers $700 million over 10 years) and was subsequently pilloried by talk show hosts and the media as an example of how the stimulus bill had turned into one big package of high priced bacon.  And - allow me to take a moment to put on my I-have-no-sense-of-humor-feminista-hat - it provided wonderful fodder for juvenile jokes by lots of male TV personalities, including my own personal hero, Jon Stewart.

Now that the jokes have run their course, and the stimulus bill is behind us, let's consider whether denying thousands of low-income women access to affordable contraception is in fact a legitimate economic issue.  On August 20, 1964, in the White House Rose Garden, President Johnson signed the Economic Opportunity Act, which established the Office of Economic Opportunity to direct and coordinate a variety of educational, employment, and training programs that were the foundation of President Johnson's War on Poverty. What we may have forgotten from our history lessons is that the Office of Economic Opportunity granted the first funds ever to support domestic family planning programs. President Johnson's calculation was simple: one key factor to individual economic opportunity is the ability to plan and space the number of children you have. Because the surest route to poverty is young, single parenthood. 

But don't take my word for it - consider the statistics. According to an analysis of census data conducted by the nonpartisan National Campaign to Prevent Teen Pregnancy and Unplanned Pregnancy, two-thirds of families begun by a young, unmarried mother are poor.  And a child is nine times more likely to grow up in poverty if the mother gave birth as a teen, the parents were unmarried when the child was born, and the mother did not receive a high school diploma or a GED. It is a spiral we know all too well - a study by S.D. Hoffman shows that only 40 percent of mothers who have children before age 18 graduate from high school, and only two percent complete college.  By comparison, 75 percent of women who delay childbearing until they are 20 or 21 finish high school and nine percent complete a college degree. The House Committee on Ways and Means in studying these numbers determined that in the last 20 years, the median income for college graduates has increased 19 percent while decreasing for high school dropouts by 28 percent. I'm no financial wizard, but this income disparity sure sounds like a pretty serious economic issue to me.

Sure, there are those who will say all women have to do is abstain from sex until they are married and their economic futures will be secure. But now that we have a president in the White House who is actually interested in evidence, we can acknowledge once and for all that the $1.5 billion the Bush Administration spent on abstinence only programs didn't work - 88 percent of teens who pledged virginity in middle and high school still engaged in premarital sex, they are just less likely to use condoms or any other form of contraception. This helps explain why the United States has one of the highest rates of teen pregnancy in the developed world and why at least one in four teen girls has a sexually transmitted disease. And it's why every reputable health organization, including the American Medical Association, has denounced abstinence only programs as ineffective. By contrast, we know that using contraception does work - according to the Guttmacher Institute, publicly funded family planning services help women avoid approximately 1.4 unintended pregnancies a year, pregnancies that would have resulted in 640,000 unintended births and 600,000 abortions.

I was thinking about Congressman Boehner's disdain for the idea that access to affordable contraception could ever be considered an economic issue the other day when I was visiting one of our clinics in North Carolina. A young patient was gracious enough to allow me to sit in and observe her visit with one of our clinicians. She was there to get long-acting contraception and during the discussion the doctor asked her where she was going to college. She named her targeted schools and said her goal was to double major with the hope of one day being an occupational therapist. She was excited for her future and taking responsibility for it at the same time. As I sat there listening to her, I wished that Congressman Boehner could pay attention to what she was saying. I think this young woman could have taught him a thing or two about economics that he has never had to learn.