Sunday, May 10, 2009

Obama's Budget: Shortchanging Women's Health?

While women's health activists were pleased to see that President Obama ended funding for abstinence-only education, they're sharply critical of other aspects of his planned budget, leading me to believe that the 100-day honeymoon is over. The Center for Reproductive Rights issued a statement saying the group is "deeply disappointed with President Obama's failure to strike government funding restrictions on abortion." Planned Parenthood says the budget "misses an opportunity to build on one of the nation's most effective programs in reducing unintended pregnancies"—namely the Title X program that funds family-planning clinics for poor women who don't have health insurance. Besides ending funding for abstinence-only education programs and providing $178 million for evidence-based comprehensive sex-ed programs, the new 2010 budget:

  • Includes an increase of $10 million in Title X family planning programs. That doesn't keep pace with inflation, according to women's health experts, who were hoping for a $400 million increase.
  • Includes an option for states to expand programs for family planning to families who earn too much to qualify for Medicaid but not enough to afford health insurance—up to $37,000 in yearly income. A Guttmacher Institute study finds this option would enable 500,000 women a year to avoid unplanned pregnancies.
  • Doesn't allow for federal funds to be used to provide abortions for those in the military or Peace Corps or those covered by Medicaid. "We would have liked for federal health insurance to include all reproductive healthcare, including abortion," Nancy Northup, president of the Center for Reproductive Rights, tells me. "After all, Obama did support it on the campaign trail."

I asked Northup to give me a report card on some of the changes in policy on key women's health issues I predicted would occur after Obama was elected. Here's how he's doing so far, in her opinion:

1. No more federal funds for abstinence-only education.
Grade: A

2. No more global gag rule. On George W. Bush's first day as president in 2001, he reinstituted the "global gag rule" that restricted federally funded clinics in foreign countries from performing abortions or even providing referrals for abortion. Obama rescinded the rule soon after taking office. Grade: A

3. Better coverage for family planning. Federal coverage for abortion services has been a disappointment to Northup and others. But discounted birth control pills may soon be available again on college campuses, and health insurers have indicated they may stop charging women higher insurance premiums, thanks, in part, to Obama's efforts. Grade: C

4. Reversal of the " conscience " regulation that threatens women ' s access to birth control. Obama has taken steps to reverse a rule put in place during Bush's last days that allows doctors and other healthcare workers to opt out of certain practices that some of them find morally objectionable—like prescribing birth control pills, inserting IUDs, or dispensing emergency contraception to rape victims—without fear of losing their jobs. The rule was opposed by most medical organizations. Obama has issued a rule deleting the Bush one; the new regulation could go into effect later this year. Grade: A (for effort)

5. Increases in funding for reproductive health clinics that serv e the uninsured. Obama's measly increase in Title X funding is disappointing. Grade: D

6. Improved access to pills and abortions for U.S. military women serving overseas. Grade: F

Grade average: C-plus

It goes without saying that Northup's grades don't necessarily represent the majority view, since Americans have varying opinions on all of these issues. How do you think Obama is stacking up so far when it comes to women's health issues? Is he passing or failing? Would he make honor roll?

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