Reproductive Health Should Not Be a Victim of the NH Budget Process
With an October 1 deadline looming for a new state budget, a critical issue that hasn’t received much attention is the disastrous impact of Governor Sununu’s veto on funding for reproductive health for New Hampshire residents.
Earlier in the year, reproductive health advocates were dealt a huge blow when the Trump administration decided to add new restrictions to federal funding under the Title X Family Planning Program for health care clinics that provide abortions. For 50 years, Title X has provided federal money to organizations like Planned Parenthood to provide reproductive health services to low income patients who frequently don’t have health insurance. These services include family planning and contraception, cancer screenings, sexually transmitted disease (STD) testing and treatment, pregnancy testing, and hormone therapy. (They do NOT include abortion care services because Section 1008 of the Title X statute and 42 CFR 59.5(a)(5) prohibit abortion as a method of family planning.) In the case of Planned Parenthood, 67% of all patients using its services are low income patients who benefit from over $3 million each year in discounted and free health care. The affordable birth control that Title X provides helps prevent one million unintended pregnancies each year.
The Impact of the Gag Rule
In March 2020, new federal restrictions on providers who accept Title X funding will go into effect. They impose a “gag” rule that prohibits doctors, nurses, hospitals, and any other provider in the Title X program from telling patients how they can safely and legally access abortion services—even in cases where the patient asks for a referral. This rule has effectively forced New Hampshire family planning providers to make a choice between their ethical responsibility to inform their patients and one of the main sources of available funding for the reproductive health of their low income patients.
To date, 6 of the 9 providers, including Planned Parenthood of Northern New England and the Joan G. Lovering Center in Greenland, have announced they are leaving the program because of the gag rule. The ones that do will lose as much as 25% of their operating revenue, putting them under tremendous financial strain. Over the next two years alone, Planned Parenthood of Northern New England projects to lose over $1.6 million in federal funding. The Joan G. Lovering Center will lose $111,000 annually.
So What Does This Have to Do with the New State Budget?
The budget vetoed by the governor would have increased state funding to make up for the loss in federal Title X funding. The state already distributes General Funds to these providers, but the new budget would have increased the amount to ensure low income residents would get the information and the care they need.
But offsetting the loss of Title X funding was only part of the story. The new budget also would have:
Restored $350,000 in funding for a STD/HIV prevention program cancelled during the Bill O’Brien years. This comes at a time when STDs like chlamydia, gonorrhea, and syphilis are making an explosive comeback at least in part because of cancellation of prevention programs. (More)
Removed a barrier to abortion care by eliminating an unnecessary budget footnote preventing Medicaid from coverage abortion care.
Increased Medicaid reimbursement rates for family planning and treatment services across the board.
Unless this funding is restored in the final compromise budget, it’s very likely that New Hampshire will see an increase in unplanned pregnancies and STDs—along with increased social services expenditures that all too frequently come along for the ride when politicians try to make medical decisions. Additionally, the long-term financial viability of providers opting out of Title X funding could be affected to a point where some are forced to raise the price of services beyond the means of many patients to pay for them—or even to close their doors.
What Now?
The good news is support for abortion access in New Hampshire remains high, with 64% of residents saying abortion should be legal in most or all cases. Only Vermont and Massachusetts have higher percentages. New Hampshire is also one of the least restrictive states in the country when it comes to laws such as waiting periods that throw up barriers to women trying to use services. Meanwhile, ready availability of family planning and contraceptive services have led to New Hampshire having one of the lowest rates of unplanned pregnancies in the country. Teenage pregnancies in the Granite State are also among the lowest.
The bottom line is New Hampshire’s support for reproductive freedom combined with convenient access to family planning and reproductive health providers makes our state one of the better states in the country for young women.
That’s why it’s critical for whatever budget compromise that emerges between the governor and the legislature takes us forward when it comes to reproductive health—and not backwards.