Family planning is an essential part of health care. Access to health care providers is fundamental in maintaining basic health and well-being. Yet, the Trump administration and the Department of Health and Human Services (HHS) is attacking access to family planning at every level.
The actions by this administration and HHS both directly and disproportionately impact women, people of color and low-income people.
As a student studying social work at the University of Hawai‘i at Mānoa and co-president of Planned Parenthood Generation Action at UHM, I am working with my fellow students to ensure reproductive rights and health care accessibility on campus, particularly by discussing the importance of the Title X family planning funding program and its impact at the state and federal level.
The Guttmacher Institute estimated that for every dollar in public expenditures on family planning, taxpayers save an average of $7. For more than 40 years, Title X has served as the nation’s only federal family planning program. Coverage under this program includes a range of basic health care services including everything from birth control to STI testing. Title X covers low income, uninsured, underinsured and those who would otherwise lack access to these services.
This year, the administration announced a new rule, effectively creating a “gag rule” that interferes with the provider-patient relationship and violates core ethical standards in health care by forcing Title X providers to withhold abortion care information from patients.
Hawai‘i has challenged this rule in the courts and Gov. David Ige has requested $2.4 million in the state budget to continue to provide family planning services if these rules are enforced.
For Hawai‘i residents, these funds are even more crucial when considering that 90 percent of individuals who receive Title X funds currently maintain an income below the federal poverty line. In 2017, this included more than 16,000 individuals.
Furthermore, many rely on Title X funds for confidentiality protection to ensure safe access to sensitive services. However, the thousands who depend on low or no-cost contraception for medical or personal reasons will now face further barriers to obtaining the most basic health care.
To put the importance of access to family planning services into perspective, consider that recent studies have found that half of pregnancies are unintended. We know that a woman’s ability to exercise control over her reproductive autonomy is crucial in pursuing the same educational, economic and social opportunities historically afforded to men.
Since the 1965 and 1972 Supreme Court rulings granting women the right to access birth control, more women have been able to break the glass ceiling. Contrary to previous generations, a greater majority of women in the United States are attending higher education and entering the professional workforce.
However, beyond contraceptive use, birth control can be used for a number of other reasons to prevent and control a range of health conditions - reducing the social stigma on women, transgender and non-binary individuals and empowering them to live their lives to the fullest.
For some people, the combination of hormones reduces the risk of endometriosis, ectopic pregnancy, heavy menstrual flow and cramping, acne, bone thinning, and ovarian and endometrial cancers, which can be costly in time away from day-to-day activities and services.
Beyond attempts to defund family planning, overall coverage has also been threatened. As of October 2017, the administration issued two new rules impacting access to birth control coverage under the Affordable Care Act that allow employers and universities to decide not to cover birth control based on religious or moral grounds.
While the courts stopped these rules from going into effect, we know that they will continue to be a threat while this administration is in control and anti-family planning judges continue to be appointed at an alarming rate.
For example, students and faculty who receive health care coverage through a college or university health plan across the country may see changes to their coverage. Universities such as Grace College have sought to take advantage of the religious exemption waiver at the expense of their community.
Students sued and won back the right to generic contraceptive coverage. At UH Mānoa, we believe in kuleana and community, and so we must acknowledge that the exemptions have the potential to affect the academic participation, success and future of the individuals of our community who depend on university insurance.
Under the leadership of Generation Action with members of the student body at UH Mānoa, petition signatures were collected to announce our stance of solidarity with other universities and employers who publicly affirm the uninterrupted coverage of birth control which faculty and students both deserve and need regardless of what is mandated at the state or federal level.
In November, Generation Action presented the petitions and asked UH Chancellor David Lassner and the Mānoa administration to publicly declare that any insurance policy or provider selected by our university will honor the right of the campus community to have equitable access to a non-politicized educational environment and opportunities free of sex-based discrimination.
We are thrilled to report that the administration of UH Mānoa recently did just that in a public statement affirming that the university will always cover birth control under any chosen insurance policy provided by our school. You can find this statement on our Instagram, @GenactionHI, and on Facebook, Generation Action Hawaii.
Any additional information about Title X or the Trump administration and HHS domestic gag rules can be found on the Planned Parenthood website at plannedparenthoodaction.org. For other inquiries or questions, Generation Action at UH Mānoa can be reached at firstname.lastname@example.org.