In a budget referred to [15] by New York Times columnist Paul Krugman as "nothing to cheer about," President Obama's fiscal year (FY) 2012 budget request nonetheless proposes increased funding for reproductive health and family planning programs here and abroad, drawing lines in what is sure to be a contentious battle with the House GOP leadership, whose proposed Continuing Resolution (CR) all but eliminates the same programs.
The president’s budget proposes to allocate $327 million to the Title X [16]family planning program, a $10 million increase over last year's request. It also maintains the current level of funding, $110 million, for the Teen Pregnancy Prevention Program [17].
Title X funding provides essential health services, especially to low-income women, through a network of more than 4,500 community-based clinics that include State and local health departments, tribal organizations, hospitals, university health centers, independent clinics, community health centers, faith-based organizations, and other public and private nonprofit agencies. Approximately 60 percent of women who receive care in a family planning health center say that such centers-provide their main source of affordable health care. The vast majority of these women and their families live at or below 150 percent of the federal poverty level, and two-thirds lack health insurance, underscoring just how vital these programs are to people otherwise likely to go without primary preventive care.
According to the Department of Health and Human Services [16]:
Over the past 40 years, Title X family planning clinics have played a critical role in ensuring access to a broad range of family planning and related preventive health services for millions of low-income or uninsured individuals and others. In addition to contraceptive services and related counseling, Title X-supported clinics provide a number of related preventive health services such as: patient education and counseling; breast and pelvic examinations; breast and cervical cancer screening according to nationally recognized standards of care; sexually transmitted disease (STD) and Human Immunodeficiency Virus (HIV) prevention education, counseling, testing and referral; and pregnancy diagnosis and counseling. By law, Title X funds may not be used in programs where abortion is a method of family planning.
So for many low-income women, access to Title X clinics may, for example, mean the difference between early detection and early treatment of cervical cancer, or early death from the same.
The budget also proposes $769.1 million for bilateral and multilateral international reproductive health and family planning assistance—an increase of $121 million or 19 percent above the $648.5 million that Congress appropriated in FY 2010.
The proposed increase in international family planning funding "is especially significant," notes Population Action International [18] (PAI), "in light of the difficult economic and budgetary climate and the spending freeze being imposed on domestic programs."
Most of the requested international funding for reproductive health and family planning ($722 million) is for bilateral programs administered by the U.S. Agency for International Development (USAID) [19], which provides family planning assistance in more than 50 countries. The bulk (625.5 million), according to PAI, is for the Global Health and Child Survival (GHCS) [20], an increase of $101 million above current levels. The remaining $96 million is contained in other bilateral accounts, a $28 million increase above current levels.
Of the $769 million requested overall, $47.5 million is proposed for a U.S. contribution to the U.N. Population Fund (UNFPA) [21], which provides critical reproductive and sexual health care in more than 150 countries. The proposed $7.5 million cut from the current contribution of $55 million is "the only disappointing development contained in the President’s request [for these programs]," said PAI.
Yet, despite the proposed funding increase, said PAI, "family planning still remains out of reach for the 215 million women in developing countries who do not want to become pregnant but need contraception."
Reproductive and sexual health advocates praised the allocations for reproductive health in the proposed budget, while also warning about the battle ahead, as Republicans seek to slash or eliminate these very same programs.
“Planned Parenthood applauds President Obama for calling for an increased investment today in an essential women’s health care program, the national family planning program, Title X," said Cecile Richards, president of Planned Parenthood Federation of America.
The president’s newly released budget for Fiscal Year 2012 demonstrates that this administration has the foresight to preserve programs that save money and save lives. The White House has taken a strong stand to prevent teen pregnancy through evidence-based approaches, and to sustain the nation’s bedrock family planning program, Title X.
But, she noted, "The new leaders of the House are pushing... dangerous proposals forward at great risk to women, and they are doing so at their own political peril."
Under the guise of deficit reduction, House Republicans are working aggressively to eliminate the Title X program, which has provided lifesaving preventive and primary care for low-income women since President Nixon signed it into law in 1970. Health centers funded through Title X save women’s lives by detecting breast and cervical cancer at early stages, by offering testing and treatment for sexually transmitted infections, screening for high blood pressure, and providing immunizations.
These clinics also prevent nearly a million unintended pregnancies every year, thus reducing the need for abortion. And family planning also saves the government money — about $3.74 for every dollar invested.
Nonetheless, notes Richards:
“While working to cut off funding for the Title X program, Representative Mike Pence, with the full support of Speaker John Boehner, will also offer an amendment to prohibit all Planned Parenthood health centers from receiving any federal funds for any purpose, including providing affordable cancer screenings, birth control, HIV testing, and treatment for sexually transmitted infections."
"Eliminating the Title X program at a time like this would not just be shortsighted," stated Richards. "It would be cruel."
On the international front, House Republicans also are proposing extreme cuts, according to PAI.
The Republican spending bill contains a 39 percent cut for international family planning when compared to the President’s FY 2011 request, sinking from $716 million to $440 million. House Republicans also aim to eliminate funding for UNFPA, the lead international agency providing family planning services to the poor and hard to reach around the world.
"The President’s budget request stands in stark contrast to the extreme cuts being proposed by House Republican leadership in a spending bill to fund the federal government for the remainder of the current fiscal year," said PAI. "These cuts will be debated this week and if passed would return the funding level for overseas family planning programs to the woefully inadequate amount of four years ago."
In addition to cuts, the GOP leadership is pushing to reinstate the Global Gag Rule.
Moreover, said Craig Lasher, Director of Government Affairs at PAI, “The cuts to international family planning are extreme and out of touch with the views of ordinary Americans."
Polls consistently show that Americans overwhelmingly support overseas family planning programs, including 69 percent of Independent and Republican voters, according to PAI. "Family planning is one of our most cost-effective foreign assistance programs and it supports U.S. diplomatic, development and national security priorities."
The GOP push to impose a permanent Global Gag Rule in a spending bill solves no financial issues and further restricts the ability of poor women to access desperately needed, family planning services. For many of these women, family planning clinics are the first entry point into the health care system. A November 2010 poll showed the majority of Americans do not support re-instating the Global Gag Rule.
Fully funding international family planning programs would reduce the annual number of abortions around the world by 14.5 million and reduce the number of women dying in pregnancy and childbirth by 250,000.
"Congress’ job is to create responsible spending bills, not to advance an extreme social agenda that jeopardizes the lives of women around the world," said Lasher. "As the world population approaches 7 billion this year, contraceptives should not be withheld from the 215 million women in developing countries who want, but lack access to them. If social conservatives are serious about reducing abortion, they should use common sense and invest in family planning programs.”
Follow Jodi Jacobson on Twitter, @jljacobson [22]