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Pence’s ‘Indiana Mafia’ Guts Funding For Women’s Health Care

It turns out Vice President Mike Pence has been up to something other than praising Trump’s “broad shoulders.

Pence has been quietly working behind the scenes to carry out the Trump administration’s goal of gutting funding for women’s health care — which he helped accomplish by installing allies from his days as governor of Indiana, which Politico described as a “cadre of officials that one HHS official called ‘Indiana mafia.'”

Installing allies whom he had relationships with back in Indiana — such as Health and Human Services Secretary Alex Azar, Surgeon General Jerome Adams, and Centers for Medicare and Medicaid Services administrator Seema Verma — have helped Pence push for one of his key priorities: defunding Planned Parenthood.

Planned Parenthood provides sexual and reproductive health care to more than 4.6 million people per year. Yet Pence has been working to strip funds from the organization — a lifeline to millions of women and men who often cannot afford reproductive health care services elsewhere — since his days in Congress.

Now that he’s in the White House, Pence helped install new rules for Title X — a federal program that helps fund family planning services — that would effectively cut Planned Parenthood off from crucial federal dollars that provide those reproductive health and family planning services.

Defunding Planned Parenthood has become a rallying cry for Republicans, who believe that the health care organization should not receive funds because it offers abortion services — even though Planned Parenthood doesn’t use any federal funds for abortion services.

Yet the Trump administration’s new rules for Title X gag health care providers that receive Title X dollars from informing their patients about their right to an abortion.

Given that Planned Parenthood runs roughly 40% of the Title X clinics in the country, cutting the group off from funds would have a devastating impact on women.

The Trump administration was ultimately sued for the policy, and a federal judge has blocked it from going into effect as the lawsuit makes its way through the courts. The judge wrote in the ruling that the policy prevents doctors from doing their jobs.

Aside from trying to defund Planned Parenthood, Pence’s cronies at HHS also implemented a policy in April that allows doctors to cite religious beliefs as a reason not to treat certain patients.

Pence has a long history of trying to impose his own beliefs on women to block them from obtaining the health care they need. For example, in 2011, when he was a member of Congress from Indiana, he co-sponsored a bill that would have redefined rape in order to ban abortion.

He also signed eight anti-abortion bills into law when he served as governor of Indiana — including one that would have banned women in the state from getting an abortion if they found out their fetus had a disability. Even some anti-abortion Republican women in Indiana were opposed to the bill.

So, while Pence is a weak vice president — forced to heap praise on Trump — he has apparently been wildly successful at imposing his anti-women agenda by sneaking in his friends into key administration roles that oversee health care.

Women can thank Pence for having trouble finding health care they need and deserve.

Published with permission of The American Independent.

IMAGE: Gage Skidmore photo of Vice President Mike Pence via Flickr.

Memo To Congress: Family Planning Needs More Funding

On Thursday, March 20, Roosevelt Institute Fellow Andrea Flynn joined the National Family Planning and Reproductive Health Association for a briefing on “The Publicly Funded Family Planning Network: An Essential Partner in the New Health Care Environment.” Her prepared remarks are below.

The Affordable Care Act represents an historic investment in the health of American women and girls. It has already improved the lives of millions of Americans and will make health care accessible for many more as rollout continues. Fulfilling the promise of the ACA, however, depends on the continued support of existing programs, such as Title X, which must remain as pillars of the country’s public health infrastructure.

For more than 40 years, Title X has provided critical medical care to low-income women, immigrant women, and young women across the country.  Some have suggested that the ACA’s expanded coverage of women’s health care will obviate the need for Title X. In fact, the opposite is true. Title X will play a number of important functions in the coming years.

First, Title X will support a network of qualified family planning and reproductive health care providers who will deliver care and services to the growing ranks of insured. Clinics funded by Title X will become an even more critical building block of our nation’s health system. Even when individuals obtain coverage, many will continue to choose publicly funded clinics as their main source of care. As one of my colleagues here will further explain, during the four years following the implementation of Massachusetts’ health care reform patients continued to rely on Title X centers even after they gained insurance coverage.

Women who are already fully insured will also continue to rely on Title X clinics because they can access care with complete confidence. Issues such as intimate partner violence and religious beliefs of employers, family members, and partners, cause many women to circumvent their insurance plans when accessing family-planning services. Sadly, these concerns will persist regardless of the coverage status of American women.

Second, Title X will guarantee family-planning access to those still uninsured. The ACA was intended to provide a path to health insurance for most Americans. However, because of the Supreme Court’s decision to allow states to opt out of Medicaid expansion, fewer uninsured Americans will gain coverage than originally planned. Today, 22 states are still refusing to expand Medicaid, leaving more than 3.5 million low-income women without coverage. As a result, two-thirds of poor black and single mothers, and more than half of uninsured, low-wage workers, remain without coverage. Title X clinics will continue to be a trusted place of care for these women.

Moreover, even in states that participate in Medicaid expansion, many low-income individuals may still remain uninsured. Estimates suggest that between 25 and 35 percent of those eligible for Medicaid still do not know it, and are failing to enroll.  Many immigrants will also remain uninsured, given the federal 5-year eligibility requirement for Medicaid. And millions of others will churn among coverage plans. One study estimates that up to 29 million people under age 65 will be forced to change coverage systems from one year to the next. Individuals who fall into these categories will rely on the Title X network for quality, affordable, and confidential care.

Third, and equally important, Title X will continue to set a comprehensive standard of care for family planning and reproductive health services.

Finally, Title X clinics are a primary and trusted point of entry into the health system. Six in 10 women who receive services at a publicly funded family-planning center consider it their primary source of medical care. As such, the Title X network will continue to play an important role in ACA outreach and enrollment efforts to ensure that health coverage is realized by as many Americans as possible.

Title X is particularly important given the health challenges facing many women in the United States. However, current funding for U.S. public family-planning programs extends care and services to just over half of the women in need. Per capita, the United States spends two and a half times more on health care than other developed countries, yet Americans overall have less access to services and experience worse health outcomes. The United States reports among the highest rates of teen birth, unintended pregnancy, and maternal and infant mortality of any industrialized country. Almost half of all U.S. pregnancies – approximately 3.2 million annually – are unintended. Poor women, women of color, and immigrant women bear a disproportionate burden in this regard. They are also more likely to experience chronic disease, maternal mortality and have a lower life expectancy than women with higher incomes.

Unintended pregnancy and teen pregnancy remain persistent issues in the United States, ones that Title X has been tackling for decades. Unintended pregnancies have a number of larger health implications. Women who have unintended pregnancies are more likely to develop complications and face worse outcomes themselves and for their infants. They often receive inadequate prenatal care, and the care they do receive begins later in pregnancy. Research has shown that pregnancies that occur in rapid succession pose additional risks for both mother and child.

The U.S. teen pregnancy rate has declined dramatically over the last decade, thanks to services offered by programs like Title X. However, it is still considerably higher than in any other developed country, where rates are generally 5 to 10 births per 1,000, compared to the current U.S. rate of 29.4 per 1,000. Racial disparities are especially pronounced in relation to teen pregnancy, with teen birth rates for white women hovering around 21.8 per 1,000, while the rates for Hispanic, Black, and American Indian teens are at least twice that. Research has shown that increased access to comprehensive reproductive health information, care, and services, including a broad range of contraceptive methods, reduces rates of unplanned pregnancy among teens.

Title X has prevented these various health disparities from becoming even more troubling. With an increased investment the program could replicate its incredible results many times over, leading to significant health improvements for American women.

In times of economic uncertainty the demand for publicly funded family-planning services increases. Since the 2008 financial crisis and the ensuing recession, the need for Title X has grown dramatically, while funding levels have declined or remained flat. Over the past few years the Title X budget has been cut by $40 million. To make matters worse, the anti-family-planning and overall austerity sentiments that have since prevailed reduced and restricted family-planning budgets in many states. There have been fewer state and federal funds for women’s health during the very time that women have also lost jobs and insurance coverage.

When Title X centers lose funding, they are forced to make cuts in three places: services and supplies, hours, and staff. As a result of funding challenges, 6 in 10 Title X clinics have been unable to stock the most costly contraceptives, particularly long-acting reversible contraceptives (LARCs) such as the IUD and implants, methods considered highly effective and most desirable among women wanting to avoid pregnancy.

Family planning is first and foremost a matter of women’s health and rights. But it is also central to women’s economic security. The continued fragility of the U.S. economy and the recession’s devastating impact on low-income families requires an increased investment in family planning. American families, many of them now headed by single women, face enormous challenges. Access to affordable contraception enables women to pursue educational and professional opportunities that strengthen their families and their communities. The majority of women who participated in a recent Guttmacher Institute study report that birth control enables them to support themselves financially, complete their education, and get or keep a job.

Given the tenuous state of the U.S. economy, the vulnerability of women’s health programs in the face of unrelenting political attacks, and the fraying social safety net more broadly, public funding for family planning is more critical than ever. Continued — indeed, increased — funding of Title X will maximize the impact and reach of the ACA and ensure continued quality care for those who remain uninsured.

Thank you.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

Photo: WeNews via Flickr