A woman’s reproductive health and rights should not depend upon her zip code, but increasingly they do. The Population Institute last week released its annual 50-state report card on reproductive health and rights, and it points to alarming disparities. Four states received an A (California, New Jersey, Oregon and Washington), but 19 states received a failing grade and the U.S. grade fell from a C to a D+.
What accounts for all this? Attacks on Planned Parenthood, including physical assaults, are jeopardizing the ability of women to access contraception and other reproductive health care services. At the same time, there are efforts to cut comprehensive sex education in schools and threats to the progress we’ve made in reducing teen pregnancies. It was a bad report card for 2015, but it could get much worse in 2016 as Congress inches ever closer to cutting off funding for Planned Parenthood, slashing support for sex education programs, and eliminating Title X, the federal program that funds many family-planning clinics serving low-income households. Also, the U.S Supreme Court could uphold Texas abortion restrictions that have devastated clinic access in the state, thereby encouraging other states to infringe upon the reproductive rights of women.
The outlook in Congress is particularly threatening. In 2015 the U.S. House of Representatives voted seven times to defund Planned Parenthood, an action that would deny millions of women access to the health care provider of their choice. The U.S. House Appropriations Committee voted again in 2015 to eliminate all funding for Title X, an action that would deny millions of women access to contraception and other vital healthcare services.
Thankfully, the White House and the Senate successfully blocked these actions in the year-end budget negotiations, but the attempts to cut funding are not abating. Congress started off the New Year by sending a bill to the president’s desk that would repeal substantial portions of the Affordable Care Act, while also eliminating federal funding for the contraceptive services provided by Planned Parenthood through Medicaid and Title X-supported clinics. The president has vetoed the measure, but the political tug-of-war will not stop anytime soon.
Cutting support for Planned Parenthood, even if the cuts are offset in part by increased funding for other providers, would have a truly devastating impact on women in this country. Planned Parenthood health centers make up only 10 percent of publicly funded safety-net providers, yet they serve 36 percent of the clients seeking contraceptive services. In 103 counties with a Planned Parenthood health center, the Planned Parenthood facility serves all the women who are using safety-net clinics to access contraceptive services. Poor women and women living in remote areas would be particularly affected.
State actions on reproductive health and rights also contributed to the low grade received by the U.S. for 2015. Abortion restrictions in Texas and in other states have forced the closures of numerous family-planning clinics. Worse still, the physical assaults on family planning clinics, which range from vandalism to the devastating shooting that occurred at the Planned Parenthood clinic in Colorado Springs, will have a chilling effect, deterring some women from accessing abortions and other services.
Seventeen states received a B- or higher and four states received an A, but the trend is not encouraging, as more states are adopting arbitrary and harassing abortion restrictions that—in addition to limiting women’s access to legal abortion services—will force the closure of family-planning clinics that provide contraception. Also, 21 states in 2015 refused to expand Medicaid coverage under the Affordable Care Act, thereby denying many poor women coverage for contraceptive services.
Equally worrisome are the attacks on comprehensive sex education in public schools. Sex-education programs have made a significant contribution to the historic decline in the nation’s teen pregnancy rate, but America’s rate is still high compared to other industrialized countries, and much of the progress that has been realized could easily be lost if federal and state support for comprehensive sex ed is axed.
About half of all pregnancies in the U.S. are unintended, and limiting access to contraceptive services and sex education will only increase the number of unwanted pregnancies and, of course, the demand for abortions. This is crazy. A woman’s reproductive health should not depend on her income or where she lives, but increasingly it does. There are growing disparities between states and even between communities, as state laws and policies now vary widely, and clinics are closing in poor urban areas and remote rural communities.
Last year was a terrible one for reproductive health and rights in the U.S., but 2016 could be even worse. Stay informed. More importantly, get involved. Or next year’s report card will be a whole lot worse.