A Cautionary Case Study for Governors Looking to Defund Planned Parenthood

Iowa Gov. Terry Branstad delivers his annual condition of the state address before a joint session of the Iowa Legislature, Tuesday, Jan. 10, 2017, at the Statehouse in Des Moines, Iowa.

Iowa Gov. Terry Branstad delivers his annual condition of the state address before a joint session of the Iowa Legislature, Tuesday, Jan. 10, 2017, at the Statehouse in Des Moines, Iowa. Charlie Neibergall / AP Photo

 

Connecting state and local government leaders

What are state governments doing to prevent a repeat of a public health crisis like the one that’s hobbled Scott County, Indiana?

On the campaign trail, defunding Planned Parenthood was a prominent red-meat topic of discussion and a rallying call for core conservatives, just like repealing Obamacare was.

But repealing as something as complex as the Affordable Care Act isn’t a simple action, nor is replacing it. So it’s not necessarily surprising that some Republican leaders on Capitol Hill and in the states, like Arizona Gov. Doug Ducey, have been urging caution about rushing an Obamacare repeal through Congress. (The U.S. Senate approved a measure on Thursday that takes the first step in the direction of a repeal.)

Republicans should also be careful when addressing the sweeping calls from conservatives to defund Planned Parenthood in order to punish the organization for providing abortion services.

During Tuesday’s Condition of the State Address in Des Moines, Iowa Gov. Terry Branstad told his fellow Republicans, who now control both the Hawkeye State’s legislative chambers, that he’s aiming to defund organizations that perform abortions while redirecting “family planning money to organizations that focus on providing health care for women and eliminates taxpayer funding for organizations that perform abortions.”

Important points to remember: While some Planned Parenthood clinics perform abortions, the portfolio of health care services provided by the organization is far more expansive than just reproductive health and that no federal funds go toward abortion services.

In response to Branstad’s address, The Des Moines Register editorial board asked regarding his call to shift family planning funding to other health care organizations in the state:

The governor should specify exactly which organizations those would be. He should sit down and write the names of the entities that can provide comprehensive family planning services in Iowa. Then he should scratch those no longer in business, like Central Iowa Family Planning.

As The Register rightfully points out, rural access to health services and adequate funding for those services remains a huge challenge for Iowa, as it is for other states.

Just look at Scott County, Indiana, which has become a national poster child for what can go wrong when you mix rampant opioid abuse in a rural community with unsafe needle-sharing practices, an HIV epidemic and a struggling public health response.

Within a few months of the start of the Scott County’s HIV outbreak in December 2014, around 200 people had been diagnosed. (This week, Route Fifty examined the Scott County situation, the success of needle exchanges and how a local public health director in West Virginia is trying to prevent a repeat of the Scott County “nightmare” in his community.)

Up until 2013, Planned Parenthood had operated a rural health care clinic in Scott County, which provided HIV testing but didn’t perform abortions. Federal and state funding cuts for the organization, championed by Vice President-elect Mike Pence when he served in Congress and as a Indiana’s governor, prompted that Planned Parenthood clinic in Scott County, along with four others in rural Indiana communities, to close.

As The Indianapolis Star reported in 2015:

Patti Stauffer, vice president of public policy for Planned Parenthood of Indiana and Kentucky, said she can't make a direct link between the closure of the Scottsburg clinic — which served 1,500 patients in the last full year before it closed—and the HIV outbreak.

"But that health center was providing HIV tests in Scott County, and any positive tests would have been reported to the state," she said.

Low public health funding affects a state's ability to detect problems such as an HIV outbreak and to address them quickly, said Jeff Levi, executive director of Trust for America's Health and an HIV expert. "But some of the issues associated with this have less to do with money and more to do with policy and appropriate policy response."

Unfortunately for Hoosiers, Indiana ranks low among U.S. states when it comes to the strength of public health infrastructure, as The Star reported.

And even without a firm connection between the  Planned Parenthood clinic closure and Scott County’s HIV epidemic, the public health crisis shows the high stakes when it comes to having inadequate funding and access to health care services, especially in rural communities.

The Register’s editorial continues about Planned Parenthood’s important footprint in Iowa:

Planned Parenthood has been providing birth control, pregnancy testing, health care, disease treatment, teen pregnancy prevention programs and other services to Iowans for decades. It has the infrastructure in place to reach thousands of people, including those in rural and low-income areas.

If the governor rejects this particular organization, he should specify exactly who has the statewide ability to take its place. And he should remember school nurses and optometrists do not provide pap smears.

Inadequate public health access can have life changing impacts on communities. Fiscal conservatives should remember that ineffective management of a public health crisis can lead to unintended consequences and costs—beyond the human cost, of course.

The estimated price tag on the lifetime treatment for the HIV and hepatitis C outbreak in Scott County, Indiana, is around $100 million, which Iowa lawmakers should note is about equal to the size of the $110 million budget hole that Branstad currently is trying to fix.

It should be noted that repealing the Affordable Care Act would make it far more difficult for states and localities to treat mental illness and the substance abuse, especially states that have had high numbers of opioid-related deaths.

Could Scott County, Iowa, or for that matter, Scott County, Missouri, or Scott County, Tennessee, be the next Scott County, Indiana? If policymakers in those states and the nation’s capital aren’t careful, they very well could.

Michael Grass is Executive Editor of Government Executive’s Route Fifty and is based in Seattle.

FEATURED CASE STUDIES
Powered By The Atlas
Integrating Complete and Green Streets for Climate-Resilient Sustainable Streets
San Mateo County, CA, USA
Chula Vista creates a Digital Equity and Inclusion Plan
Chula Vista, CA, USA
Navajo County Expands Access to Social Services with Online Portal
Show Low, AZ 85901, USA

NEXT STORY: Some Fear Vote Could Make North Carolina ‘First in Flight, Last in Health’

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.