Integrating Reproductive Health - January 2002

Denver Women's Commission
Integrating Reproductive Health - January 2002

January 1, 2002
Prepared by Chaer Robert
For Colorado Woman News

Integrating Reproductive Health

For about six years when I was a young and uninsured, Planned Parenthood was my only source of health care, save the occasional visit to the emergency room. In fact, after I got health insurance it took me a year to realize I didn’t need Planned Parenthood anymore. How did we end up with one system for reproductive health that is separate from the rest of the health care system? Quite simply, Planned Parenthood was created in 1916 when the health care system refused to challenge Comstock laws banning the discussion and distribution of birth control as obscenity. This segregation of reproductive health care has continued until the present day. While access to prenatal care is pretty ubiquitous, with the State of Colorado paying for more than 1/3 of births, State funding for abortion is banned by the voter-approved initiative to the State Constitution. Both federal and state funds are earmarked for family planning. At different periods in her life, the same woman might seek birth control, an abortion, or prenatal care. But the response to her needs will be dramatically different.

Defunding of Family Planning Services by the State – For more than 20 years, Planned Parenthood has, by state contract, provided family planning, STD and cancer screenings to low-income women throughout the state. This year they served 13,000 women in Longmont, Glenwood Springs, Security, Steamboat Springs, Canon City, Alamosa, Cortez, La Junta, Lamar, Trinidad and Granby. For most, Planned Parenthood is their primary access to health care, either because they lack health insurance or because their part of the state lacks other health care providers. The State paid Planned Parenthood $78. per person toward their total cost of $200. per person.

In 1999, the State Health Department decided that to continue funding would violate state constitution. To continue to receive funds, they were forced to set up a separate organization to do abortions, which Planned Parenthood did. State funding was reinstituted.

An outside audit this year, however, concluded that Planned Parenthood could not lease space at below-market rates to the new and separate, privately-funded, organization that provides abortions—that that constituted indirectly using taxpayer money to pay for abortions. So although tax dollars did not even pay the full cost of providing family planning services, the link was too close. “We cannot award funds to Planned Parenthood because Colorado voters have twice said they do not want taxpayer dollars to directly or indirectly pay for abortions”, announced Jane Norton, executive director of the Colorado Department of Public Health and Environment.

Planned Parenthood decided not to make all the organizational changes required by the audit. They don’t think the state has the right to tell them how they have to run their organization, particularly when they have been subsidizing the provision of these services for the state. So they will keep providing the services as best they can, using patient co-pays and fundraising to replace the lose of state funding.

One key question is how the state will provide family planning services to 13000 low-income rural Colorado women without Planned Parenthood. During hearings held throughout the state by the Rural and Small Group Interim Legislative Task Force, legislators heard repeatedly about the dire shortage of health care providers in the rural areas.

Contraceptive Equity – Is prescription birth control different than other prescriptions? A 2000 Kaiser Family Foundation survey found that 60% to 87% of companies offer some sort of contraceptive coverage, an increase from 1997, when coverage ranged from 35% among small companies to 68% among large ones. In 2000, the Equal Employment Opportunity Commission decided that employers refusing to cover prescription contraceptives, while covering other prescriptions, was sex discrimination. In 2001, in Erickson v. Bartell Drug Co., a federal court agreed. Seventeen other states have now passed legislation requiring contraceptives be covered equal to other prescriptions. The laws do not require prescription drug coverage, nor do they require an employer to provide health insurance.

Protect Families, Protect Choice Coalition supports women’s reproductive health. Members include Planned Parenthood of the Rocky Mountains, National Abortion Rights Action League (NARAL), Colorado Organization for Latina Opportunities and Reproductive Rights, NOW, Responsible Choices Action Network, League of Women Voters, Women’s Lobby of Colorado, and Religious Coalition for Reproductive Choice. On January 22, the 29th anniversary of Roe v. Wade, they held Pro-Choice Lobby Day. Laws and policies are not written in stone, immutable. They are political decisions. Abstinence from pol