The U.S. Department of Health and Human Services is deliberating on what preventative services will be required under our nation’s new healthcare law (the Patient Protection and Affordable Care Act or PPACA).
There are powerful forces in and out of Congress that are pushing hard for contraceptive drugs and devices to be included among the required taxpayer funded services.
On a recent radio show, Cecile Richards, President of Planned Parenthood, argued that not only is contraception good for women’s health but is an "investment" that will save our government money in the long run by reducing unintended pregnancies.
"I think it’s important," Richards said, "to understand that unlike some other issues of cost, birth control is one of those issues that actually saves the government money.
"So an investment in covering birth control actually in the long run is a huge cost savings because women don’t have children that they weren’t planning on having and all the sort of attendant cost for unplanned pregnancy."
Planned Parenthood and its allies have been making this assertion for decades: more contraception means fewer unintended pregnancies, which results in cost savings to states from not having to pay for the expenses related to unintended pregnancies. While this argument may have some intuitive appeal, there is little evidence to back it up.
I know this firsthand because I have done my own search (which is ongoing) of publications by Planned Parenthood and its research affiliate, the Alan Guttmacher Institute, as well as the documentation provided by local groups urging our Legislature to expand funding for "family planning." What I’ve noticed with all the studies I’ve seen is that they draw conclusions based on estimates and assumptions not on hard, empirical data.
The study most often cited by these groups to substantiate their claims is a study commissioned by the Centers for Medicare and Medicaid Services (CMS). This study examined a handful of states that had expanded Medicaid contraceptive services to see if it increased use of such services and reduced unintended pregnancies.
The study claims that every state saved money by averting births, but provides no empirical data linking the expansion of contraceptive services to a decrease in unintended pregnancies. In fact, the study admits that unintended pregnancies actually increased in at least one state and some states didn’t even see an increase in use of contraception.
In contrast, there are dozens of studies (conducted by advocates of contraception) which show that greater access to contraception does not reduce unintended pregnancies and abortion. Abstracts and citations of these studies can be seen on the U.S. Bishops’ website at www.usccb.org/prolife (click on issues, contraception, fact sheets).
One of the studies you’ll find there is by James Trussell, who originated the claim that easier access to emergency contraception could "result in a greater than 50% reduction in abortion rates." According to every one of the 23 studies, published between 1998 and 2006, that Trussell reviewed, easier access to emergency contraception failed to achieve any statistically significant reduction in rates of unintended pregnancy and abortion (see Raymond, Trussell and Polis, "Population Effect of Increased Access to Emergency Contraceptive Pills," Obstetrics & Gynecology 109 (2007): 181-8).
Planned Parenthood has indicated that at both the federal and state level it will make expansion of taxpayer-funded contraception one of its top priorities. To defeat this effort, it will be critical that Planned Parenthood’s flimsy argument for increased government spending on contraception is exposed and challenged with the facts.
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