Even as a national debate rages over contraception insurance, tens of thousands of low-income women and teenagers across the United States have lost access to subsidized birth control as states slash and restructure family planning funds.
Montana and New Jersey have eliminated altogether their state family planning programs. New Hampshire cut its funding by 57 percent and five other states made more modest program trims.
But the biggest impact, by far, has been in Texas.
State lawmakers last fall cut family-planning funds by two-thirds, or nearly $74 million over two years. Within months, half the state-supported family planning clinics in Texas had closed.
The state network, which once provided 220,000 women a year free and low-cost birth control, cervical cancer tests and diabetes screenings, will now serve just 40,000 to 60,000, officials said.
Another 130,000 low-income Texas women who get free exams and contraceptives through Medicaid could lose those benefits by month’s end, due to a dispute between the state and federal governments over whether Planned Parenthood should be allowed to serve women on that program.
At the People’s Community Clinic in Austin, the cuts mean that many low-income patients, except the very poorest, are now charged for contraception that used to be free: $5 for a dozen condoms; $10 for a month of birth control pills; $225 for an IUD.
“I have no clue what I’m going to do,” said Rhetta Pope, 22, of Austin. A stay-at-home mother of two, she lives off disability payments of less than $1,500 a month.
Pope said after paying basic living expenses, she has so little left she scrimps on electricity by keeping the lights off and takes her laundry to an aunt’s house. She can’t imagine how she would pay for birth control.
“I guess I’m going to have to stop using it because I don’t have the money,” Pope said. “I’m pretty shook up. I really am.”
SAVINGS IN DOUBT
Texas legislators who backed the 66-percent family planning cuts say they had no choice – the state budget was in crisis and many worthy programs suffered.
But a budget board analysis concluded the cut would actually cost Texas taxpayers more than it saved.
The board projected that women unable to get low-cost birth control would deliver 20,500 additional babies – costing state and federal taxpayers $231 million in prenatal, maternity and infant care. The state’s share would be close to $98 million – significantly more than the family planning cut savings.
State Representative Wayne Christian, a Republican, acknowledged that the cuts might be counterproductive “if you look at it from a financial cost, perhaps.”
But he disputed the notion that additional babies were a cost burden. “We value a human life more than just the cost,” he said.
In general, he said, the state should not try to deter births by widely distributing free contraception. If women who want birth control cannot afford it, he said, they should first seek help from families or communities.
“I’m sorry,” Christian said, “but there’s this thing called individual responsibility.”
Some women have found ways to pay for the care they once received free, but many have not.
After losing much of its state family-planning grant, the Parkland Health & Hospital System in Dallas in January began charging most patients a flat $25-per-visit fee.
In the first two weeks of the policy, 362 women cancelled appointments because they could not make the co-pay. Only 20 percent found the money to get care within a week or two, hospital officials said.