On Thursday, the Senate will vote on a bill to keep government operations running that also includes a measure to defund Planned Parenthood. That vote comes after the House passed a bill stripping the women’s health organization of all federal funding last week.
The issue of defunding Planned Parenthood has now gotten tangled up in the question of whether Congress can successfully pass a bill with enough funding to keep the government open before a shutdown would kick in on October 1. Some Republicans are demanding that the organization lose its funding in return for any support of a bill that would keep the government open.
But for the party that bills itself as fiscally responsible and concerned with deficits, the move doesn’t make much sense. Beyond the fact that a shutdown itself is costly, defunding Planned Parenthood would come with a huge price tag.
Earlier this week, the Congressional Budget Office (CBO), the nonpartisan agency tasked with determining the costs of proposed legislation, released its findings that permanently stripping Planned Parenthood of federal funding would increase government spending by $130 million over a decade.
Federal funding constitutes about a third of the organization’s overall revenues, most of it from Medicaid. It’s not clear whether, how, and when Planned Parenthood would be able to replace that money with other sources, but the CBO estimated that any ability to cover the gap would eventually dry up. That would reduce reproductive care for somewhere between 5 and 25 percent of the people it currently serves, mostly women in low-income areas where few other options exist. The Guttmacher Institute recently found that among the 491 counties with Planned Parenthood clinics currently, there are no other centers in 103 of them where low-income patients can get affordable contraceptive services.
Without those services, the women in those areas would have a harder time avoiding unwanted pregnancies. The additional births would have to be covered by Medicaid, as would the needs of the children as they grew up and potentially other social safety net programs. Given all of those factors, Medicaid spending alone would increase by $650 million over 10 years, and even with the estimated savings of not giving funding to Planned Parenthood, net spending would increase.
Some places have faced the reality of these numbers. In 2011, Texas lawmakers slashed family planning funding by $73 million — but after learning that it would mean the delivery of 24,000 babies that women wouldn’t have otherwise had, at a cost of $273 million to cover the medical expenses and care for the infants, lawmakers of both parties worked to reinstate funding. Still, they pursued a state-wide family planning network that excluded Planned Parenthood, and the workaround is estimated to cost the state between $5.5 and $6.6 million. And today, more than half of Texas women say they’ve faced at least one barrier to getting needed reproductive health services.
In general, funding family planning services is incredibly cost effective. For every dollar spent on providing women with access to contraception through these programs, the federal government saves $3.74 by avoiding unwanted births. In general, every dollar spent on publicly funded family planning services come with huge savings — more than $7 — thanks to preventing unwanted births as well as through other preventative care measures such as STI testing and Pap smears.
Unplanned pregnancies also come at a financial cost to the women who have them, beyond potential emotional and physical costs. In a study, women who weren’t able to obtain an abortion were three times more likely to fall into poverty in the subsequent two years than those who were able to get one. Among women who seek abortions, one of the most frequently cited reasons is because they can’t afford to have a baby.