In a move cheered by conservatives, President Trump signed legislation on Thursday to reverse a rule signed by President Barack Obama that prevented states from denying federal funding from health centers — such as Planned Parenthood — that also provide abortion care.
The dollars in question come from Title X — the federal family planning program — which is jointly funded by states and the federal government and provides contraception counseling, contraception prescribing, and preventative reproductive and sexual health services, including testing for sexually transmitted infections and cancer screenings.
The Obama-era rule was signed to ensure that these funds go to the best family planning providers, and not to providers that meet a specific set of political criteria.
Over the past year, courts throughout the country and the federal government have made it clear to states seeking to eliminate Planned Parenthood and other independent health centers that provide abortion care as Medicaid or Title X providers that doing so is illegal. Per federal law, the only kinds of standards that states may enforce on providers to participate in these programs have to do with a provider’s ability to perform covered services.
In other words, ousting a provider for a political reason — such as because they provide non-publicly funded abortions — is never allowed.
The Title X Family Planning Program was signed into law by President Richard Nixon in 1970, and is the only federal domestic program focused solely on providing reproductive health services when medically needed, as well as educational and counseling services to both providers and communities. Approximately 4 million Americans are served by Title X each year — many of whom earn too much to qualify for Medicaid, but do not have and are otherwise unable to afford health insurance.
“These attacks are really on low-income women,” Jamila Taylor, a senior fellow at the Center for American Progress and an expert in women’s health and reproductive health policy, tells Yahoo Beauty. “If you look at the sources of federal funding that go to Planned Parenthood — one, through Title X and two, through Medicaid reimbursements — those are both pockets of money with the goal of ensuring that low-income women have access to reproductive health care. When we talk about proposals to strip funding from programs that help low-income people, we’re talking about pushing these people farther into the cycle of poverty. We’re almost saying they’re undeserving. I would encourage us to call this out as an attack on poor women.”
Taylor continues, “We know that in terms of access to health care, if we look at those who are uninsured or lack access to health care services, these are low-income people and people of color. If you delve deeper into who Planned Parenthood serves, we know they largely serve people of color and low-income people. Seventy percent of their patients have incomes below 150 percent of the federal poverty line, and 60 percent of their patients are accessing them through Medicaid or Title X. We’re really talking about stripping health care from low-income people, and when you strip health care from low-income people, this only endangers their economic security even more.”
And Taylor also emphasizes that efforts to limit or eliminate funding to Planned Parenthood are not so much an attack on Planned Parenthood but on the communities they serve.
“Planned Parenthood will still have funding from other sources; they will not close their doors. But low-income communities and communities of color who are largely underserved will not have access to a trusted provider in their community. Planned Parenthood often acts as the single access point to health care in these communities,” she explains.
In 21 percent of counties with a Planned Parenthood health center, Planned Parenthood is the only safety net provider in the county. In 68 percent of counties with a Planned Parenthood health center, Planned Parenthood serves at least half of all patients using safety net services.
Furthermore, Taylor notes, communities that rely on Planned Parenthood are also often those in poverty.
Barring Planned Parenthood from Title X “will force people to delay care because they don’t have the resources to pay for it” without access to a Title X provider — often Planned Parenthood — in their community.
“We know — for women of color and black women in particular — we know they are more likely to die of cancer, both cervical and breast. We’re going to put them at risk by delaying timely care,” Taylor says. “Even outside of the focus on defunding Planned Parenthood, people of color are more likely to face barriers to accessing health care no matter what. If they have the ability to access Planned Parenthood health centers, then they are more likely to have compassionate, patient-centered care in those spaces. Planned Parenthood facilities have a focus on ensuring that disenfranchised communities or folks that might experience discrimination in any other place have a compassionate provider in their community.”
As to what these attacks on the health care services that low-income women especially depend on to live their lives mean, Taylor says she believes that, fundamentally and philosophically, “it goes back to this deserving-versus-undeserving thing. If you focus on policies and how they are developed, they are often a way to stigmatize being poor and having public sources for health care. There is this framing of underserving these communities.”
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