At last night’s debate the GOP presidential hopefuls called yet again to defund Planned Parenthood, tripping over themselves to show who is most serious about shutting down the organization. Ted Cruz said “absolutely we shouldn't be sending $500 million of taxpayer money to funding an ongoing criminal enterprise.” Chris Christie, Scott Walker, and Jeb Bush all bragged about defunding Planned Parenthood in their states. Carly Fiorina likened the Planned Parenthood issue to the Iran threat. Kasich argued that governors should be able to strip the organization of funding, and Trump didn’t have much to say about Planned Parenthood but he did promise to “take care of women.”
In calling for the defunding of the national reproductive health provider—a move that would place basic health care and services, including family planning, out of reach for millions—the candidates are ignoring research that has over and over again show that publicly funded family planning is one of our government's smartest and most cost-effective public investments. In recent years family planning has joined abortion in conservative crosshairs, but the economic benefits it confers once made it an uncontroversial and bipartisan issue.
This is not to say the health benefits aren’t important. They are, and they have been well documented and cited. For decades Planned Parenthood and other reproductive-health providers have—with support from programs such as Medicaid and Title X, the nation’s only program solely focused on making family planning available to all—prevented or provided care for millions of unintended pregnancies, unintended births, abortions, sexually transmitted infections, and cervical cancer.
If that’s not enough—clearly, it’s not—the economic benefits of these programs are what should earn them high praise from conservatives. In a Guttmacher Institute study of women seeking contraceptive care at publicly funded clinics, 63 percent of women reported birth control had allowed them to take better care of themselves or their families, and 56 percent said it allowed them to take care of themselves financially. Half reported that it helped them stay in school and complete their education and that it helped them get or keep a job and advance their careers. In a recent poll, 72 percent of Pennsylvania voters said a woman's ability to control the timing and size of her family impacts her financial stability, and 62 percent believed that laws that made abortion harder to access can negatively impact a woman's financial security. Polls of voters in New York and Virginia showed similar results.
Access to family planning has increased women’s labor-force participation, improved their—and their family’s—economic security, and has multi-generational health and economic benefits. The National Women’s Law Center highlights research that shows the initial availability of birth-control pills in the early 1970s accounted for 30 percent of the growth in the proportion of women in skilled careers between 1970 and 1990, and contributed to an increase in the number of women in fields that are dominated by men, such as medicine and law. Women’s ability to plan and space their pregnancies has been shown to improve educational attainment and increase wages and lifetime earnings. And the children of mothers who had access to birth control have higher family incomes and college completion rates. Researcher Martha Bailey found that—relative to children conceived in the same areas before family-planning programs began—children born after the advent of federally funded family-planning programs lived in households with higher annual incomes and were 5 percent less likely to live in poverty, 15 percent less likely to live in households receiving public assistance, and 4 percent less likely to have a single parent.
Investing in reproductive health isn’t just good for women and their families—it’s good for the economy. Today it is estimated that every dollar spent on publicly funded family planning yields a savings of $7.09 in public expenditures. In 2013, publicly funded family-planning providers helped women prevent two million unintended pregnancies, one million of which would have resulted in unplanned births and 693,000 in abortions. In 2010 just over half of all births—and 68 percent of the 1.5 million unplanned births—in the United States were paid for by public insurance. That year, the government expenditures on unintended pregnancies and the associated births, abortions, and miscarriages totaled $21.0 billion. According to the Guttmacher Institute, without these services rates of abortion, unintended pregnancies, and unplanned births would have all been 60 percent higher, and the related costs could have been as much as 75 percent higher.
It’s estimated that the potential savings from averting all unintended pregnancies would be in the ballpark of $15 billion. That’s a far cry from the $2.37 billion America spent on publicly funded family planning in 2010 (75 percent in Medicaid expenditures, 10 percent in Title X, and the rest in state appropriations, block grants). In 2013, those programs served 8.3 million women—only 42 percent of those in need of publicly funded care.
Despite these savings, the Republican candidates contend that family-planning spending is off the charts, but that is certainly not the case. Between 2010 and 2013, Congress reduced Title X spending by 12 percent, while the number of women in need of publicly funded family planning services grew by five percent, or a total of 918,000 women. When accounting for inflation, today’s Title X budget is two-thirds of what it was in 1980. In 2015, Congress appropriated $286.5 million for Title X (down from $317 million in 2010), but if funding had kept pace with inflation over the past three decades, the current level would be in the ballpark of $850 million. In addition to the drop in funding, state regulations on Title X funding have altered the reach of the program. Today Ohio, Michigan, and Texas have tiered funding systems that prioritize state health-department clinics and crisis pregnancy centers, leaving little to no money for the very family-planning clinics the funding was originally intended. Kansas and Oklahoma prohibit private family-planning providers from receiving state and federal funding and many other states prevent organizations that also provide abortion services from receiving funding.
In recent weeks, GOP lawmakers and candidates have rejected the accusation that they are waging a “war on women” and have said they don’t intend to entirely defund women’s health care—just the organization they don’t believe is in the business of delivering it. The funds currently going to Planned Parenthood, they’ve suggested, can simply be redirected to other organizations that could provide the same services. But there are not enough other providers to take on the patients currently being served by Planned Parenthood, and defunding the organization would place an “untenable stress” on the community health centers conservative lawmakers say could manage the overflow. To make matters worse, much of the funding for those centers is granted through the Affordable Care Act, which—after 55 failed repeal votes—Republicans are still eager to overturn. The fact that abortion represents a small percentage of Planned Parenthood’s total services, and that federal law already prohibits taxpayer dollars from being spent on abortion in nearly all circumstances, has not deterred conservatives in their quest to shutter the organization.
But there’s reason to conclude that the GOP actually is interested in slashing women’s health funding generally, not just for places like Planned Parenthood. In 2011 and again in June of this year, the party proposed eliminating Title X. In 2013, GOP lawmakers shut down the federal government in opposition to the Affordable Care Act’s contraceptive coverage requirement.
At the end of the debate Fiorina made an appeal to women voters:
What I would think is that we ought to recognize that women are not a special interest group. Women are the majority of this nation. We are half the potential of this nation, and this nation will be better off when every woman has the opportunity to live the life she chooses.
This is a nice sentiment. But by restricting reproductive health access—and opposing paid family leave, an increased minimum wage, and pay equity—Fiorina and her colleagues will actually make it much more difficult for women to live the lives of their choosing. And, in doing so, they’ll hold back America’s economy too.