Long-acting reversible birth control methods, like intrauterine devices and contraceptive implants effective for three to 12 years, have long been considered too costly to be paid for by public funding through the Title X family planning program that started in the 1970s.
But studies showed LARC programs cut down the number of unwanted pregnancies. So in 2009, the Family Planning Initiative was launched by the Colorado Department of Public Health and Environment, providing dozens of Colorado’s clinics with the financial means to offer LARCs.
Initially funded by the Susan Thompson Buffett Foundation, the $27.3 million pilot program provided IUDs and implants to 30,000 women in Colorado. The plan was to prove that funding the program would work to cut teen pregnancy rates and then use data collected to convince the government to fund LARCs.
The program showed LARCs worked in Colorado. But when CDPHE came looking for public money for the program, Republicans blocked it.
In data released by CDPHE in July of 2014, the state saw its teen unintended pregnancy rate drop 40 percent and abortion rate down 35 percent from 2009 to 2013 after the program was launched.
And since the last session, more proof that the program works to cut the numbers on teen pregnancy and abortion just keeps rolling in.
The latest data for 2014 released in October shows that the initiative was even more effective that year: Unintended birth rates for women ages 15 to 19 fell 48 percent.
What made this Colorado health initiative so unique and so successful is that it gave young women a choice of birth control options. Once the cost barrier was removed, women overwhelmingly chose long-term contraceptives over daily or monthly birth control methods.
Data from the Centers for Disease Control shows that LARCs are more effective in blocking unwanted pregnancy than the pill or male condoms. While the CDC does encourage people to use condoms to prevent STI transmission, intrauterine devices and implants are the agency’s preferred birth control methods.
“A lot of people who have an unintended pregnancy are using birth control, but typically, they aren’t using it correctly,” said Ellen Marshall of the consulting firm Good Works Group, which operates Before Play, the advocacy and public education arm of the Family Planning Initiative.
“These methods, like the pill, are 99 percent effective… with perfect use. But that’s always the glitch: the perfect use.”
In offering long-acting reversible contraception along with health-and-family-planning education, safe-sex advocacy and outreach, more women were able to make choices that fit their lives, said Marshall.
Though the multi-million dollar grant allowed for the Family Planning Initiative to succeed in its first six years, the funding was never meant to be permanent.
In April of this year, Democratic Rep. KC Becker and Republican Rep. Dom Coram proposed legislation that would have allocated $5 million in public financing for the program.
“If we talk about the scope of teen pregnancies, every minute a child is born to a teen mother,” said Coram. “It’s a great cost to our society, not only for the young people whose lives have been changed, but for their children’s lives. Basically, it is a sentence to poverty.”
His fellow Republicans did not agree with his perspective or the overwhelming data showing the program’s effectiveness. They struck down funding with an 18-17 vote.
“Ultimately we hit some very ideological arguments that this (greater access to birth control) is going to lead girls to be more promiscuous,” Becker told The Independent. “But there’s no evidence of that.”[pullquote]”“We estimate that we can prevent abortions and save a lot of money, and that’s kind of a win for me.” — Republican LARC bill sponsor Rep. Kathleen Conti[/pullquote]
Those voting against the bill made arguments unfounded in actual data. Republican Rep. Kathleen Conti said the initiative could lead to higher STD rates.
“The rate of sexual activity as reported through our studies has not increased as a result and the rate of sexually transmitted diseases has not increased over this period of time as well, said CDPHE head Larry Wolk, championing the bill on the House floor last session. “These devices do not prevent or protect against sexually transmitted diseases, but we have other strategies.”
Coram said the bill did more than just cut down on teen pregnancies. It also decreased the birth-related costs carried by the Colorado Medicaid program.
“We estimate that we can prevent abortions and save a lot of money, and that’s kind of a win for me,” said Corman, who opposes abortion, on the floor. “We can save $5.85 for every $1 invested in the program.”
CDPHE estimates that the state saved between $49 and $111 million dollars in birth-related Medicaid costs.
So where is the program now?
After Republicans killed it, private groups stepped in to replace the slashed funding. In August organizations including Kaiser Permanente Colorado and the Women’s Foundation of Colorado pledged $2 million in bridge funding to keep the program going until lawmakers could successfully pass a bill.
Once again, this private funding is not meant to be a permanent solution.
Becker believes that as a matter of public health, the state must step in.
She is hopeful that Gov. Hickenlooper will include LARC funding in his upcoming November budget request and hopes Republicans can keep their ideology out of effective public health policy so that the program can continue uninterrupted.
“Making sure people are having babies when they’re ready means that they are more likely to be strong, stable families,” says Becker. “We are just continuing to see that this shouldn’t be any more controversial than anyone choosing one form of birth control over the other. We want to fund what is really achieving results.”
Last week, Hickenlooper outlined his 2017 $27 million state budget proposal. It included a request for $2.5 million in public funding for LARC programs — half of what is needed for the service to continue.
Today the legislature’s Joint Budget Committee will begin reviewing Hickenlooper’s budget proposal.
The fate of Colorado’s proven reproductive health care program remains unknown.
Photo credit: Charlotte Cooper, Creative Commons, Flickr.