As the number of low-income women who need government assistance to access family planning services has been on the rise, the number of patients served by publicly funded clinics has been falling, according to new data from the Guttmacher Institute. The gap helps illustrate the widening gulf between poor women and wealthier women when it comes to their ability to use reproductive health services, a disparity driven partly by partisan attacks on abortion.
“The number of women needing publicly funded contraceptive services has skyrocketed over the last decade,” Rachel Gold, Guttmacher’s acting vice president for public policy, said in a statement regarding the findings. “But public funding sources — such as the federal Title X program and state revenues — are failing to keep pace with women’s growing needs.”
Several decades ago, there was broad bipartisan support for government funding to help impoverished women manage their reproductive health. When President Nixon was in the White House, he declared that “no American woman should be denied access to family planning assistance because of her economic condition.” In order to make that vision a reality, the federal Title X program was created in 1970 to fund family planning clinics across the country. Today, Title X remains the only public family planning program of its kind, and those clinics are essential health care providers for the low-income families who rely on them.
But over the past several years, as anti-abortion Republicans turned their attention to attacking Planned Parenthood, Title X got caught in the crossfires. GOP lawmakers have repeatedly cut family planning budgets on the state level. In 2011, Republicans in the House of Representatives voted along party lines to defund Title X.
Title X has managed to hang on, but its clinics are now struggling to keep up with the demand. According to Guttmacher, there were an estimated 20 million low-income women in need of Title X’s services in 2012. That’s an increase of about 3.5 million women since 2000. In that same time period, the number of patients served by publicly funded clinics dropped. While public clinics met about 41 percent of low-income women’s need for family planning services in 2000, they met just 31 percent of the need in 2012.
The issue has recently been getting worse. In the period between 2010 and 2012 alone — when attacks on publicly-funded clinics intensified — the number of poor adult women in need of contraceptive services increased by 12 percent. In Texas, where lawmakers’ crusade against abortion has undermined the entire family planning landscape over the past two years, this health care crisis is coming into sharp focus. Advocates are holding up the state as a negative example of what happens without Title X.
It’s no wonder, then, that unintended pregnancies are increasingly becoming concentrated among low-income women who don’t have an adequate safety net to turn to. However, there aren’t very many good options for them after they become pregnant, either. Thanks to the federal policies that prevent taxpayer dollars from funding abortion services, it’s typically difficult for those women to pay hundreds of dollars out of pocket to end a pregnancy. And if they’re ultimately forced to give birth, they’re more likely to slip deeper into poverty.
The fact that the safety net is failing low-income women has broader implications for reproductive health policy, too. The individuals who support Hobby Lobby, the crafts chain that sued for the right to drop coverage for certain types of contraception on religious grounds, typically claim that women don’t need insurance coverage for birth control because they can just get it from government-funded programs. But Title X’s ongoing struggles prove that’s not exactly realistic for the estimated 62 million U.S. women currently in their reproductive years.