Providing women inexpensive, long-acting contraceptives is one of the most effective anti-poverty programs in the world. Ensuring that as few people become parents before they intend to allows more women and men to get an education, get a foothold in the work world and develop the life skills they need to successfully manage their own lives — before becoming responsible for someone else.
Not getting pregnant in the first place eliminates the need for a woman to even consider an abortion, a policy approach that should enjoy broad support across the political spectrum.
So it is outrageous that congressional Republicans, who now control both the U.S. House and Senate, have targeted a highly effective federal family-planning program for elimination, imperiling the health and the futures of millions of poor and rural families throughout the United States and affiliated territories, including tens of thousands of people in Hawaii, American Samoa, Palau, Micronesia and Guam. Impoverished women will suffer the most.
Hawaii’s congressional delegation must fight hard to preserve Title X, which has been chipped away at in previous federal budget cycles, caught in the ongoing political battle over legal abortion — even though not a single penny pays for abortion services — and the victim of some Republicans’ unyielding and misguided desire to undermine President Barack Obama’s every aim.
When Title X was enacted in 1970 with huge bipartisan assent, Republicans and Democrats in both chambers recognized the importance of providing lower-income and rural residents access to the contraception, testing and treatment for sexual transmitted diseases, family-planning counseling and lifesaving screenings for cervical and breast cancer and other diseases that wealthy women in urban areas take for granted.
Now a U.S. House subcommittee seeks to eliminate all $300 million in Title X funding from a 2016 spending bill, cuts that, if approved, would take effect next fiscal year.
That this sensible, effective grant program, which works in tandem with other funding sources, never as the primary bill payer, could become such a perennial target highlights the misogyny that rots at the core of some “budget-cutting” arguments. Effective family-planning programs save U.S. taxpayers more than they cost, by encouraging women to take control of their reproductive health and delay childbearing until they and their partners have the means to support the children they bring into the world.
“If we want to reduce poverty, one of the simplest, fastest and cheapest things we could do would be to make sure that as few people as possible become parents before they actually want to,” Isabel Sawhill, an economist at the Brookings Institution, told The New York Times. In her 2014 book “Generation Unbound: Drifting Into Sex and Parenthood Without Marriage,” Sawhill makes the case that long-acting birth control methods, such as the IUDs and implants that Title X-funded clinics provide, are powerful tools to prevent single parenthood, which she cites as a driving factor of economic inequality.
In 2013, Title X-funded providers served 4.6 million patients throughout U.S. states and territories, including 20,603 in Hawaii — 19,519 women and 1,084 men — according to the National Family Planning and Reproductive Health Association.
Roughly $2.2 million in annual Title X funding to Hawaii flows through the state Department of Health, which disperses it via contracts that augment services at about 30 health-care centers statewide, including Kalihi-Palama Health Center, Kokua Kalihi Valley Comprehensive Family Services, Koolauloa Community Health and Wellness Center, Waimanalo Health Center, Waianae Coast Comprehensive Health Center, Bay Clinic, Hamakua Health Center, Community Clinic of Maui, Lanai Community Health Center, Molokai General Hospital, Kauai Community College Wellness Center, the University of Hawaii-Hilo Student Health Center, and Planned Parenthood on Oahu and Maui.
These community-health centers are vital to the state’s overall well-being and they need every penny they can get, as they reach the neediest of Hawaii’s residents. Indeed, 74 percent of the Hawaii residents treated at Title X-funded facilities earned $13,230 a year or less; 84 percent earned less than $33,075 a year, according to the association.
Title X grants are not the sole source of funding for these Hawaii facilities, obviously, but they are an important one, a necessary lifeline amid the rapidly shifting health-care landscape. Supporting Title X is not only the right thing to do, it’s the smart thing to do, for families, communities and taxpayers alike.