Planned Parenthood to Iowans: ‘$1 now or $4 later?’

When it comes to making family planning services available and accessible to low-income women, Planned Parenthood of Greater Iowa has a question for Iowa officials and taxpayers: “Do you want to pay $1 now or $4 later?”

Iowa has roughly 100,000 low-income women — 12.3 percent of all women of childbearing age — who need, but are not receiving, publicly assisted family planning services. The lack of access has been costly to Iowa, a state where half of all pregnancies are unintended. Planned Parenthood is advocating for the development of a state fund that would be used in conjunction with Medicaid, the Medicaid Waiver, Title 10 and other federal funding streams to provide low-income women with the birth control they need.

Kyle Carlson, staff attorney for PPGI, says that creation of the fund is the agency’s No. 1 legislative priority.

“Iowa ranks 39th in terms of state assistance and 48th in terms of access to birth control for low-income women,” he said. “As we’ve known for a while, that just isn’t good enough.”

The legislative priority received a boost at the beginning of the legislative session when Gov. Chet Culver tentatively earmarked $1 million for the fund. With legislators poised to tighten the state’s belt, the climate in Des Moines is not necessarily conducive to new appropriations.

“We looked at other states around us and found many of them already had these types of state funds,” Carlson said. “The interesting thing about this program, and the programs we’ve modeled it after, is that they are showing a significant return on investment.”

Neighboring Minnesota, according to Carlson, has determined that for every dollar placed in the family planning fund, the state experiences a $4 Medicaid cost savings. Similar programs have also met with success in Michigan, Wisconsin and Illinois.

“Whenever I’m approached and told that the state has a really tight budget, I say that the governor has given us $1 million to help make this fund happen, and, if we’re successful, we’re going to get you four back,” Carlson said. “It’s actually a cost-saving mechanism for the state. It’s just a question of whether we want to pay a $1 now or $4 later. We know we could significantly save a lot of Medicaid spending by putting this money into prevention.”

The hope is that the family planning fund, once created, would be a pool that would grow over time. With the initial $1 million from the governor, an additional 2,500 Iowa women could be served — $6 million could serve 15,000 women.

“Our goal is to progressively increase the fund over time as much as we can,” Carlson said. “For now, however, getting the fund created is a step in the right direction.”

Planned Parenthood is also advocating on behalf of a bill that would require health insurance companies to provide coverage for the human papilloma virus vaccine.

“We are incredibly optimistic about the HPV insurance language because it is moving in the House and it is moving fast,” Carlson said. “It came through the House Human Resources Committee before Feb. 1. I believe that is very telling about the type of support behind this.”

For the most part, insurance companies have remained neutral about the bill. Carlson says this stems from the fact that most insurers who cover vaccinations have already included the HPV vaccine.

“Really this is about the state making a long-term commitment to women,” he said. “This is the state saying that it is going to prevent cervical cancer as a matter of policy rather than leaving it to market forces.”

While other states have used such measures as one stop along a path to mandating the vaccine for girls attending school, Carlson said that is not the case in Iowa.

“I know that there are some other places where that approach has been taken,” he said. “That has never been an approach for us.”