This week Jeb Bush made a slip of the tongue that let us know just where he stands on reproductive health. "I'm not sure we need half a billion dollars for women's health issues," he said at an event in Nashville. In a way, he's right: We actually need much more than half a billion dollars to fully meet the need for publicly funded reproductive health services. Bush has since backtracked on his comment, which came on the heels of Senate Republicans' failed attempt to defund Planned Parenthood, but we should not be fooled. His remarks and the recent furor that led to said defunding attempt are a clear illustration of the resentment GOP lawmakers and candidates have for our nation's reproductive health programs, and reflect their resolve to diminish them.
It's important to consider Bush's remarks and the attacks on Planned Parenthood in the political context of the past four years. As Elizabeth Warren indicated in her impassioned speech before the Senate this week, over the past five years Republican state lawmakers have passed nearly 300 new restrictions on reproductive health access. In the first quarter of 2015, lawmakers in 43 states introduced a total of 332 provisions to restrict abortion access, which is increasingly out of reach for women throughout the country. Republicans have voted more than 50 times to repeal the Affordable Care Act (ACA), which has dramatically improved women's health coverage and access. In the fall of 2013, the party orchestrated a costly government shutdown motivated by their opposition to the ACA's contraceptive mandate. And in June, House Republicans proposed eliminating funding for Title X, the federal family planning program.
When conservatives talk about "women's health" funding, they aren't talking about funding for abortion. Federal law already prohibits public dollars from being spent on abortion or abortion-related care. They're talking about funding for family planning and other reproductive health services (pregnancy counseling, cancer screenings, STD treatment, etc.), which mainly comes through Medicaid and Title X, two programs that are consistently in conservative crosshairs.
There are no two ways about it: Funding for public reproductive health programs is far below where it should be. Today funding for Title X is 70 percent lower than it was in 1980 (accounting for inflation). If funding for this program had kept up with inflation over the last 35 years, the current funding level would be $941.5 million. In 2015, Congress appropriated $286.5 million for Title X (down from $317 million in 2010).
Congress approved these funding decreases (and Republican senators have proposed even further cuts while their House colleagues have proposed complete elimination of Title X) despite a growing need for services. The Guttmacher Institute reports that between 2000 and 2010, the number of women who needed publicly funded contraceptive services and supplies grew by 17 percent and by 2013 had grown by an additional 5 percent (an additional 918,000 women). Guttmacher attributes this to an increase in the proportion of adult women who are poor or low-income; the current US public family planning program is only able to serve approximately 42 percent of those in need. Turns out "half a billion" isn't quite enough.
"Title X-funded health centers provide essential preventive care to millions of women and men across the country and are often the only source of health care they receive all year," said Clare Coleman, President and CEO of the National Family Planning & Reproductive Health Association. "The network of publicly funded family planning providers has long been underfunded despite a growing need for these vital services."
Title X-funded clinics - of which some, but not all, are Planned Parenthood providers - are the backbone of the nation's reproductive health care system, ensuring that low-income individuals, young people, immigrants, and women of color are able to access affordable, quality reproductive health services. Every year, nearly 5 million individuals rely on these providers for birth control, breast and cervical cancer screenings, pregnancy testing, and a range of other preventive services. In 2012, Title X clinics helped women avert 1.1 million unintended pregnancies that would have otherwise resulted in 527,000 unplanned births and 363,000 abortions. In addition to the extraordinary health benefits, Title X is smart economics. It's estimated that every dollar invested in family planning yields a taxpayer savings of $7.09, and that Title X-funded clinics save more than $5 billion annually in pubic spending.
Conservative lawmakers have spent much more time in recent years finding ways to restrict access basic health care than they have solving the actual problems that plague women and families like pay inequity, low wages, weak worker protections, and a lack of work-family benefits. If recent events are any indication, they're not going to veer from that course now. Jeb Bush's recent remarks, the hoopla over Planned Parenthood, and the relentless assault on reproductive health and rights is a clear reminder of where issues central to women and families fall on the priority list of conservative lawmakers: dead last.