Limiting Access in America to Family Planning Has a High Cost

In a 163-page rule-changing document, “Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act,” as of last month some U.S. women will have more difficulty obtaining birth control.

Drafted in terminology invoking moral convictions and religion, the new rules roll back the contraception mandate in the Affordable Health Care (Obamacare) by exempting “a wide range of employers from the requirement that they offer birth control to their employees without co-pays or deductibles,” as reported by the Los Angeles Times.

Mark Edwards wrote in an opinion piece for Newsweek, “All of us – our families, our communities, our economy – pay a price when there are barriers to contraceptive access.” There’s a tremendous public cost in the U.S. when access to birth control is limited, Edwards writes. Almost half of all U.S. pregnancies (that’s 1.5 million births) are unplanned, and two-thirds of the prenatal care, labor and delivery, postpartum healthcare and infant care costs are paid for with $21 billion in public funds.

Costs continue from there and include women halting their education to take care of child and thus lowering their income-earning potential, among other costs.

Not providing access to contraception is counterintuitive and goes against core findings that are well known about family planning. The Guttmacher Institute documents the need for, access to and use of contraceptives and provides the evidence base for public investment in high-quality and affordable family planning services that provide a full range of methods, comprehensive and accurate information, and effective counseling. Guttmacher articulates the value of contraception very well:

“When women and their partners have access to a wide range of contraceptive methods, they are better able to plan and space their births. This leads to positive health, social and economic outcomes for women, families and society.”

Educating and empowering women and girls is the mantra among organizations involved with family planning issues and groups working to lower poverty rates and to help create conditions for a sustainable global population. When women and girls are denied rights it contributes to higher fertility, because they are denied self-determination and social power, according to the Population Media Center.

Unfortunately, an unenlightened and unpragmatic view of family planning out of step with a First World country tends to pervade the policymaking of Republican administrations. This latest reduction in public health care services related to family planning is just one more example. Since Ronald Reagan, Republican administrations also have instituted the global gag rule which bans international organizations from receiving U.S. aid if they provide abortions or offer information on abortions – Republicans make it a first order of business when in power to impose the global gag rule, and Democratic administrations revoke it, causing a funding yo-yo, which impacts all other family planning services.
 
President Trump followed Republican course on the global gag rule, and the impacts are being felt. This in in line with the impacts of past pulling of funds. For instance, when the George W. Bush administration instated the global gag rule, a 2011 Stanford University study found that abortion rates more than doubled in sub-Saharan Africa. 

Good policy that contributes to healthy outcomes for females – and thus for all – should be a nonpartisan issue. Republicans need to end 30 years of playing political football with the most basic health and welfare issues.