Last week, John McCain and Jeff Flake both voted in favor of overturning an Obama-era law that prevented states from taking away Title X funding from health clinics that perform abortions.
And while that change in policy is unlikely to affect Arizona right away, it could be disastrous for women in the long run.
It’s entirely possible that you’ve benefitted from Title X without ever realizing it. As Planned Parenthood Arizona’s President and CEO, Bryan Howard, describes it, “This is the single biggest funding source solely dedicated to birth control in the nation.”
But it’s not limited to birth control: Title X funding also pays for cancer screenings, fertility and pregnancy care, testing for sexually transmitted infections in both men and women, and well-woman exams.
In Arizona, roughly 36,000 people benefit from the Title X program each year. Many of them are people of color, live in rural areas, or have little to no income. 82 percent of them are female, and 69 percent are uninsured.
If that last number seems shockingly high, it’s because Title X-funded clinics serve as a safety net for people in a variety of different situations who would ordinarily slip through the cracks and be unable to see a doctor.
In some cases, patients have insurance, but choose not to use it. For instance, women who are in abusive relationships may have partners who do not want them using birth control. In order to avoid unplanned pregnancies, they have to see a doctor without their partner finding out, which means not using insurance.
“There’s definitely a privacy and confidentiality issue if you have to go to somebody else to get the insurance benefits,” Howard says. “If you’re a 16-year-old living at home, you think you may become sexually active and you don’t want the risk of an unintended pregnancy, you want to get on birth control, but you don’t necessarily feel comfortable going to your mother or father to get that insurance card.”
Some of the uninsured patients who come to Title X-supported clinics are likely undocumented immigrants, he adds, since they’re unable to participate in the state’s Medicaid program. “When they come to a Title X-funded health center, it’s just not a question we ask,” he says.
And lastly, Howard notes, signing up for insurance under the Affordable Care Act can be tricky to navigate. “There are people who would probably be eligible, but found it too difficult or too confusing to be enrolled,” he points out.
Missed open enrollment, but need a breast exam? Your local Title X-funded clinic has you covered.
“If a woman walks into the door of a Title X-funded health center, she will get care,” Howard explains. “They are guaranteed to get care that day, no questions asked. And that’s what makes it so important.”
According to the Arizona Family Health Program, the rate of unintended pregnancy, unplanned birth, and abortion in the state would be 27 percent higher if Title X-supported services weren’t available. The teen pregnancy rate would be 22 percent higher.
“For years and years, this was a bipartisan, mainstream program,” Howard says. “It’s really unfortunate that people like Mr. McCain and Mr. Flake are choosing to make it a political issue.”
Conservatives dislike the fact that Title X funding helps clinics that provide abortions stay open — despite the fact that the funding doesn’t go directly to abortions. Apparently, they hate it so much that they’re willing to ignore the fact that those same clinics also provide care for women who are pregnant, or trying to get pregnant, in addition to potentially life-saving cancer screenings.
H.J. Res 43, which would allow states to take federal funding away from those clinics, has already passed Congress. The usual suspects (Andy Biggs, Trent Franks, Paul Gosar, David Schweikert, and Martha McSally) voted in support.
It was less popular in the Senate, deadlocking at 50-50, but Vice President Mike Pence came along and cast the deciding vote which allowed it to pass to President Trump’s desk. He’s expected to sign it.
So once states can take away that funding from clinics that also perform abortions, what does that mean for Arizona?
Well, in the short term, nothing’s going to change. The state’s Title X funds are distributed by the Arizona Family Health Partnership, a nonprofit that contracts directly with the federal government and doesn’t report to politicians.
In the long term, though, the change in federal policy could potentially open the door for the state legislature to try and prevent Planned Parenthood — which operates the majority of Title X-funded clinics in the state — from getting that funding.
“Under this new rule, there are conservative states that are going to try and wrestle away the money, so that it’s controlled by the legislature, rather than by a public health organization,” Howard says.
Considering that the Arizona Family Health Partnership has been successfully managing the state’s Title X funding for more than 30 years, “it would be pretty insane to say, ‘Let’s give it to a group of state bureaucrats,’” Howard says.
But, he points out, “a lot of insane things have been happening lately.”
Dr. Julie Kwatra, an obstetrician gynecologist in Scottsdale who also serves as the legislative chairperson for Arizona’s chapter of the American Congress of Obstetricians and Gynecologists, is even less optimistic.
“I would not be surprised if that was the first thing on the docket next year, to restrict Title X funds from Planned Parenthood,” she says. “Would that be legal? I don’t know. But clinics would have to close, because this is their lifeline.”
She points to Texas — where maternal mortality rates nearly doubled and the birth rate among low income women shot up after funding cuts forced 82 family planning clinics to close — as an example of why taking Title X funding away from Planned Parenthood would be a disaster for Arizona.
“All women should have access to the health care that they need,” she says. “Those funds should not be limited by the state legislature. As a physician, I can tell you that it’s a terrible idea. That’s a no-brainer.”