How family planning programs save taxpayers billions of dollars each year

Washington PostOctober 14, 2014Articles

Publicly-funded family planning services help low-income Americans avoid serious health conditions while saving billions of dollars each year, according to a new analysis — benefits that go beyond providing contraception that can prevent unintended pregnancies.

Past research from the Guttmacher Institute, a research organization that supports publicly funded family programs, already found that family planning services helped prevent an estimated 2.2 million unintended pregnancies in 2010, which would have resulted in about 1.1 million unplanned births.

A new Guttmacher report out Tuesday morning finds that the public investment in family planning actually saved taxpayers $13.6 billion in 2010 from the costs of those unintended pregnancies, as well as from other services the programs provide, like testing for sexually transmitted infections and cervical cancer.

About 9 million women received contraceptive services from publicly supported providers in 2010, costing about $2.2 billion and accounting for about one-third of all women who received such services that year. Most of these publicly funded visits occurred in Title X-supported health centers, as well as Medicaid physician offices, report author Jennifer Frost and her colleagues write in the new study published in The Milbank Quarterly.

Title X funding, in particular, has come under attack from some conservatives in recent years. Some objected to the federal family planning funds going to groups that provide abortion services, like Planned Parenthood. Mitt Romney called for the elimination of Title X during his 2012 campaign, while Texas Gov. Rick Perry and the conservative state legislature cut state family planning dollars by two-thirds in 2011 – only to restore some of the cuts two years later after too many facilities closed or stopped providing those services.

The Guttmacher report is a reminder that family planning services are about much more than just contraception. More than 90 percent of these publicly funded providers offer screening for HIV and sexually transmitted infections, like chlamydia and gonorrhea. Catching these diseases early can pay off down the road through immediate treatment and long-term changes in a patient’s behavior.

According to the report, about half of female clients (or 4.4 million in 2010) at these publicly funded centers were tested for chlamydia, the same amount for gonorrhea, and 19 percent received an HIV test in 2010. Without access to these services, about 3.2 million women wouldn’t have been screened for chlamydia or gonorrhea, the authors estimate. That would have meant “tens of thousands of undetected and untreated STIs,” and that includes the prevented transmission of these infections to partners. The numbers here are pretty striking — Guttmacher researchers estimated this reduced chlamydia infections by an estimated 99,100 cases; gonorrhea infections by 16,240; HIV infections by 410.

There are life-saving benefits, too. The report estimates that 3.2 million women received a cervical cancer test during a publicly funded family planning visit in 2010, including 2.3 million who otherwise would have forgone such screening. That helped identify 3,600 potential cases of cervical cancer, averting 2,090 deaths from the disease, the authors estimate.

Now to the estimated cost-savings. By avoiding 2.2 million unintended pregnancies in 2010, Medicaid paid $15.2 billion less than what it otherwise would have for maternity care and infant care through a child’s first five years. Medicaid would have spent another $409 million on care for miscarriages from these unintended pregnancies, and the 17 states that use their own funds to pay for abortions for Medicaid enrollees saved an estimated $44 million. The authors estimate another $123 million was saved through testing for STIs and HIV, as well as another $23 million from Pap and HPV testing and vaccines.

In all, these savings meant a $7.09 return on investment for each public dollar spent on family planning services in 2010, according to the report. Even when the authors adjusted the assumptions made to reach these numbers, “the most extreme and unlikely scenarios would still produce substantial cost savings,” the authors write.

The report looks at 2010 data, which is before the Affordable Care Act’s coverage expansion took effect. The law’s new coverage scheme, especially in states that expanded their Medicaid programs, should mean an increase ease in patient visits to publicly funded health centers and Medicaid providers, the authors write. That means more opportunity for improved health outcomes and even more savings.


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