There is no joy in Mudville. Our house values have plummeted, and our portfolios and pensions were worth more a decade ago than they are today. A whopping 7.6 percent (and growing) of us are unemployed, while the rest of us are worried about losing our jobs. The hemorrhaging job market leaves an additional 14,000 Americans every day without health insurance, according to the Center for American Progress Action Fund, a left-leaning think tank.
No surprise, many of us are now praying that our birth control doesn't fail us, and some women have consciously decided to postpone having a baby in this recession. Many of those left without insurance have been swarming into Planned Parenthood clinics to get free or subsidized contraception. In fact, a spokesperson from the Planned Parenthood of Southeastern Pennsylvania tells me it has seen a 10 percent increase in the number of women coming into its local centers in the past three months, many of whom are recently unemployed. The Yuma Planned Parenthood in Arizona saw 260 new patients from November 2008 to January 2009, up from 171 new patients during the same period a year earlier. And the affiliate in east-central Iowa now adds about five or six women each day to its patient roster where it used to add about that many a week. "We also get about 10 to 20 calls a day from women who recently lost their health coverage or are worried about the what-ifs," says Jennifer Vick, the affiliate's director of development and communication.
There's no doubt that these family planning services, partially subsidized with your tax dollars, do a great service, especially as more of us find ourselves unable to afford basic healthcare necessities like a yearly Pap smear or monthly birth control pills. In fact, a Guttmacher Institute report released today has calculated that publicly funded services, at both hospitals and nonprofit clinics, save taxpayers $4 for every $1 spent by preventing nearly 2 million pregnancies and 810,000 abortions every year. "Having the ability to make decisions about when or whether to have a child is even more critical during these economic times," study author Rachel Benson Gold tells me, "especially as women struggle to complete their education or hold down a job." What's more, the report found that 6 in 10 women who come to these centers consider it to be their usual source of medical care. "They get their annual Pap and pelvic exam, screening for sexually transmitted infections, a blood pressure check, breast exam," Gold says. "It's pretty much the same level of care that you get on your yearly gynecologist visit."
About 10 Planned Parenthood affiliates—out of 97 nationwide—offer primary-care services. Mar Monte, an affiliate in California's Santa Cruz region, has about 10 clinics that treat everything from diabetes to high cholesterol to ear infections. "About 85 percent of our patients are women, but we also treat men," says Cathy Bright, service director at Mar Monte.
Can anyone walk into a Planned Parenthood clinic and get free services?
"No, it doesn't work that way," explains Gold. "To get free care in most states, you must qualify for Medicaid." My jaw drops when she tells me that in order to receive Medicaid coverage, states require your income to be well below the poverty line of $18,310 for a family of three. In some states, the cutoff is $11,000 in annual income; in Arkansas, it's $3,113. On the other hand, Arkansas and 20 other states have implemented Medicaid waivers for pregnancy care and family planning services, which has raised the qualifying income level typically to about $37,000 for a family of three or about $21,000 for a single woman.
Still, that excludes most unemployed women from coverage if they're receiving unemployment benefits or have an employed spouse. The folks I spoke with at Planned Parenthood clinics tell me that they work with every patient to provide affordable care. At Mar Monte, fees are assessed on a sliding scale based on income, and Bright tells me that they're "considerably more reasonable" than what many middle-income women would normally pay out of pocket for contraceptives or lab tests. At the Iowa affiliate, Vick says, staff exhausts all funding options—including grants from other organizations and donations from community members—before billing a patient directly. "We ask what she can afford and take it from there," she says.
Now if only we had such a stop-gap system in place to cover the rest of our health needs, like mammograms, appendicitis operations, colonoscopies....
It brings to mind a friend—lacking health insurance—who for years met her reproductive healthcare needs by visiting Planned Parenthood but failed to get a proper diagnosis for a serious gastrointestinal disease. After being hospitalized with life-threatening intestinal inflammation and bleeding, she was stuck with a bill for $35,000.