Republicans call for de-funding Planned Parenthood in state; health secretary says that would lead to more teen pregnancies

By Melissa Patrick
Kentucky Health News

Republican gubernatorial candidate Matt Bevin and the state House GOP caucus are calling for de-funding of Planned Parenthood in Kentucky, but Democratic Gov. Steve Beshear and his health secretary say the Republicans don't understand how federally funded family planning and women's health services work.

Planned Parenthood has come under attack because of edited, undercover videos published by the anti-abortion group Center for Medical Progress that show officials of Planned Parenthood afifliates in other states discussing sale of fetal body parts after abortions. Planned Parenthood, which does not do abortions in Kentucky, says it facilitates transfer of fetal parts for medical research, and any fees it charges are to cover its costs of handling and shipping.

Matt Bevin (Lexington Herald-Leader)

After Republicans in Congress moved to stop funding of Planned Parenthood, Bevin issued this statement: "As governor, I will direct my secretary of the Cabinet for Health and Family Services not to distribute federal taxpayer dollars from that department to Planned Parenthood clinics. Federal taxpayer dollars appropriated to Planned Parenthood flow through the governor’s administration. As governor, I will prevent those dollars from being distributed, and order them returned to the federal government."

Then all the Republicans in the state House, except Jim Stewart of Flat Lick and Tommy Turner of Somerset, signed a statement saying in part, "Recent highly publicized videos have, in astounding detail, demonstrated the appalling and cold-hearted willingness of top employees of Planned Parenthood to violate federal law and human conscience by profiteering from the flesh and organs of aborted babies. Kentuckians will not tolerate the distribution of their tax dollars to this organization, and call upon the governor and attorney general to immediately and forever terminate all funding to Planned Parenthood."

The attorney general is Bevin's Democratic opponent, Jack Conway. Asked to comment on Bevin's call, Conway's campaign did not directly address the issue, saying in an email, "Attorney General Conway does not support public money being used for abortion services and supports Kentucky's ban in place on government funding being used for abortion services."

Conway supports women's right to abortion. CN|2's "Pure Politics" reports that Conway's 2002 congressional campaign received $5,000 in contributions from the Planned Parenthood Action Fund political action committee.

The State Journal in Frankfort reported Beshear's response to Bevin: “No state money goes to Planned Parenthood. The only federal money that goes to Planned Parenthood that we know of goes to our public health departments on a local level. And one or two of them contract with Planned Parenthood to do some of the clinical work that public health departments do. It has nothing to do with abortions, it has to do with family planning. So I don’t really see any issue to get all riled up about. Matt Bevin has proven over and over again he doesn’t understand any of these issues.”

The House Republicans said that once the money comes to Kentucky, it becomes state money and they don't want it going to Planned Parenthood, even through intermediaries.

Bevin told Terry Meiners of WHAS Radio in Louisville that Planned Parenthood plays a "shell game" with its funding.

Audrey Haynes (image from cn|2)

Audrey Haynes, secretary of the Cabinet for Health and Family Services, said many people mistakenly believe federal funds authorized by Title X of the federal Public Health Service Act that wind up with Planned Parenthood go for abortions, which some Planned Parenthood affiliates in other states perform.

"No! It is illegal to pay for abortion," Haynes said in an interview with Kentucky Health News. "Title X is not about abortion, it is about women's health."

Haynes, who was President Clinton's director of women's initiatives and outreach, said Title X money and Kentucky's recent expansion of Medicaid under federal health reform ensure all women access to women's health services, and reductions would have "compounding effects," such as increasing teen pregnancies.

The Guttmacher Institute, a research organization that supports abortion rights, says more teen pregnancies lead to more abortions: "Services provided by clinics that receive some Title X funding helped women avert 1.2 million unintended pregnancies in 2010, preventing 590,000 unplanned births and 400,000 abortions. Without the services provided by Title X–funded clinics, the U.S. unintended pregnancy rate would be 35 percent higher and the rate among teens would be 42 percent higher," the institute says. "Overall, 50 percent of unintended pregnancies result in an unplanned birth, 34 percent in an abortion and 16 percent in a miscarriage; these percentages vary slightly for poor and low-income women and for teenagers."

Haynes said that of the more than 400,000 Kentuckians recently made eligible for Medicaid, about 214,000 are adult women, and 70,000 women on Medicaid used Title X services in 2014. The services are also available to the 9.5 percent of Kentuckians who still don't have health coverage.

For the 2015-16 fiscal year, Kentucky received $5.4 million for Title X family planning and women's health services, and Planned Parenthood gets about 6 percent of it.

The money is divided between local health departments, which then decide if they want to provide these services directly or subcontract them out, or both. Two departments, in Louisville and Lexington, sub-contract a portion of these services to Planned Parenthood, which receives a total of $331,300 of Kentucky's federal Title X funding, according to the Cabinet for Health and Family Services.

Both departments have other family-planning subcontractors; Family Health Centers of Louisville gets $374,653 and Bluegrass Community Health Center in Lexington gets $23,532.

Asked why the Planned Parenthood money couldn't be shifted to the other contractors, Haynes said that is a decision for the health departments, but said she suspects that those decisions "have something to do with the locations of those local health clinics," and denying funding to Planned Parenthood would mean that some women needing services would not be served.

Combined, the Louisville and Lexington Planned Parenthood offices saw more than 4,700 patients last year.

“Banning federal funding for Planned Parenthood would have a devastating impact on women, men and families, especially those in medically underserved communities and with low incomes," Betty Cockrum, President and CEO of Planned Parenthood of Indiana and Kentucky, said in a statement.

Contraceptive services are some of the most utilized services provided by Title X funding and by Planned Parenthood.

"How many unwanted pregnancies that we would certainly have and what that would do to the social and human services equation in our state?" Haynes asked, saying such services have helped greatly reduce the teen-pregnancy rate in Kentucky and other poor states.

Kentucky's teen birth rate dropped to 39 per 1,000 teens in 2013, less than half the rate recorded in 2003, according to the latest Kids Count report. And fewer teens in Kentucky are having sex, though almost half of them (44.7 percent) report they are sexually active, and more of them are using some form of birth control when they do, according to the Kentucky Youth Risk Behavioral Survey.

More than half of the women in the U.S. who received clinical services provided through Title X are in their 20s, while 21 percent are under age 19, according to the cabinet.

Most women who use federally funded family planning are young and poor. At Planned Parenthood in Lexington, 19 percent of its patients are 19 or under and 56 percent of them are in their 20s. In Louisville, 17 percent are 19 or under and 59 percent are in their 20s. Both locations serve a poor population, with 59-60 percent at or below 100 percent poverty and 74-73 percent at or below 150 percent poverty, respectively.

Legislation or executive action to de-fund Planned Parenthood would likely face a legal battle.

Three states, Alabama, Louisiana and New Hampshire, have recently said that they are cutting off Medicaid payments to Planned Parenthood, but "the laws governing Medicaid don't allow exclusion of certain providers solely because of other medical services they provide, such as abortions," CBS News writes, and will "likely face a court challenge," Susan Fogel, director of reproductive health for the National Health Law Program, told CBS News.

The U.S. Senate blocked Republican legislation to cut off federal funding to Planned Parenthood Aug. 3. Senate Majority Leader Mitch McConnell voted against the measure, saying he did so not because he doesn't want to de-fund Planned Parenthood, but because of a procedural rule that will now allow him to bring the issue back for another vote.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Religious business owners and corporations have filed half the lawsuits over health reform mandate to cover contraception

By Molly Burchett
Kentucky Health News

Some religious business owners are filing suit against the government, saying the health-reform law violates the constitutional freedom of religion by mandating employee contraceptive and abortion-inducing drug coverage; the lawsuits are expected to land in the U.S. Supreme Court, and a case filed by Hobby Lobby is the first of this kind to be heard by a federal appeals court.

Challenges to the mandate that will require businesses with more than 50 employees to provide no-cost coverage of all contraceptives, sterilization procedures, plus education and counseling, are not just coming from Catholic entities with a religious, moral objection to contraception. About half of the cases have been filed by corporations, reports Robert Barnes of The Washington Post.

There are now 60 cases involving 190 individuals representing hospitals, universities, businesses, schools and people opposed to the mandate, says the Becket Fund for Religious Liberty. The Becket Fund maps the cases, as shown below; for the interactive version, click here.

Since the law mandates contraceptive coverage, groups such as Catholic bishops have accused the Obama administration of waging war on religious liberty, reports Barnes. In February, the administration announced an exemption for faith-based organizations from covering employees' contraception costs because the conceptions would be covered by a third party. Self-insured organizations like Catholic schools sued, arguing that the accommodation would not apply to them because there is no third-party insurer to cover contraception. But those cases have been dismissed in court because such organizations are given a one-year grace period to comply with the mandate, reports Laura Bassett of the Huffington Post.

Businesses don't qualify for faith-based exemption from mandates

Hobby Lobby's David and Barbara Green

Business do not meet the new exemption either, because they are not religious organizations. However, some businesses like Hobby Lobby, which was founded and is still owned by an evangelical Christian family that believes life begins at conception and already covers contraceptives through existing employee health coverage, are fighting the law's mandate to cover abortion-inducing drugs or devices, like morning-after and week-after pills.

"They ought to be able — just like a church, just like a charity — to have the right to opt out of a provision that infringes on their religious beliefs," said Kyle Duncan, who argued the case Thursday before the 10th Circuit Court of Appeals on behalf of the Green family, and a sister company, Christian booksellers Mardel Inc, reports The Associated Press.

Other suits have been filed by religious business owners of diverse enterprises, from a company that makes wooden cabinets to owners of Panera Bread restaurants, reports Barnes, but all the cases base their arguments on the First Amendment guarantee of free exercise of religion and on the Religious Freedom Restoration Act of 1993. The Hobby Lobby case also specifies that the mandate violates freedom of speech and the Administrative Procedure Act because it was imposed without prior notice or sufficient time for public comment.

In the early stages of litigation, lower courts have split on the issue. Some have rejected Hobby Lobby's request for an exemption to the mandate, and requests by other businesses for a temporary injunction, saying for-profit businesses aren't covered by the faith-based exemption. However, courts in St. Louis and the Seventh Circuit have granted temporary injunctions. (Read more)

Christian Co. Health Dept. to stop providing cancer screens, contraceptives to residents of other counties

As of Jan. 1, the Christian County Health Department will not provide contraceptives or cancer screening to indigent patients if they do not reside in the county. Nick Tabor of the Kentucky New Era reports the department will provide those services to other counties' residents if the county in which they reside has signed a contract with Christian County before the Jan. 1 deadline agreeing to repay Christian County for those services. Tabor writes that the policy is not applicable to those services that are covered by state or federal government reimbursements.

The health department's move was prompted by a budget deficit that is close to $200,000, some of it traceable to a lack of reimbursement for contraceptive care. Mark Pyle, director of the department, told Tabor that residents of both Todd and Trigg counties often seek services in Christian County and Christian county taxpayers foot that bill. Pyle explained that there’s nothing in state law saying the health departments have to serve anyone who comes in, regardless of residence.

The New Era is behind a paywall. To obtain a subscription, go here.

Will birth-control mandate cost more or less? Yet to be seen

Will requiring insurance companies to provide contraception be cost-neutral, as the Obama administration claims? It is unclear, and so is whether insurance companies will make Catholic institutions pay more. These were the findings of FactCheck.org, a nonpartisan, nonprofit, consumer-advocate project funded by the Annenberg Public Policy Center of the University of Pennsylvania.

In support of its claim, the administration cites data from Hawaii's birth-control mandate, which shows health insurance premiums "did not appear" to increase. The study also found the number of pregnancies increased after contraception coverage was required.

But when Pennsylvania considered imposing a similar mandate, a state agency found "the amount of possible savings relative to the cost of the legislation is unclear." Findings were also unclear in Connecticut when officials there looked at whether or not insurance plans saved enough because there were fewer pregnancies to offset the cost of providing coverage. A Texas study found insurance companies would not save enough because women would buy contraception on their own.

A recent survey of 15 insurance companies found six thought costs would increase and another three felt the move would be neutral in cost. None felt they would save money because of the mandate.

"Until better data are available, we're unable to conclude whether the Obama birth-control mandate is likely to result in a net cost increase or not," FactCheck reports.