This is a follow-up to "Dems About To Collapse On Contraceptives In Stimulus Plan???". According to Elana Schor at TPMDC, "Family Planning Aid is Gone For Good From the Stimulus". True or not, we need to fully realize just how bad this is, so we understand the parameters that Obama is operating within. Hopefully they can and will be changed, but we cannot be effective in changing them if we don't understand them--particularly if we will fully mis-understand them. First off, Robert in Monterrey, aka "Eugene" had an excellent recommended diary at DKos yesterday, "This Is Not Acceptable", hitting three main points at the crux of the matter:
Why does this battle matter? First, contraception is economic stimulus. Family planning is necessary for American families of all incomes to enjoy financial stability and the ability to plan expenses. If you have an "oops baby" then your finances may suffer severely and unwantedly.
Second, this is a conservative effort to destroy the Obama Administration in the womb. If Obama caves, as now appears likely, then Republicans will have won a truly major victory. They never had a chance to stop the stimulus, but now they will have shown they can dictate some of its terms. They were active in pushing their bullshit talking points to the media - flawed as they were. If Obama is going to cater to their whims, we know from the Bush era how this story ends - Republicans will make more crazy demands, and Democrats will give in to them.
Third, this is part of the conservative effort to attack not just abortion rights, but contraception and the right to privacy. What they have done, and what Obama is about to enable, is something rather stunning - they have made contraception controversial. Sure, some of us might have felt a bit sheepish the first time we bought condoms or picked up the pill at the pharmacy, but we got over it, because it's not controversial or shameful but normal.
Not to the conservatives. They never wanted to stop at rolling back Roe v. Wade - they want to roll back anything smacking of sexual freedom. Griswold v. Connecticut is their true goal, the 1967 case that outlawed bans on contraception and established the right to privacy. If they are going to have a chance at rolling that back, they have to make contraception controversial. And if we are to stop them, we must not yield an inch to them - we must stand up and say "no, you lost, and we are keeping contraception funding."
As dday observes at Hullabaloo, Obama is sacrificing "what works" for conservative ideology.
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In an update to his diary, Robert/Eugene noted:
dhonig has offered some valuable links showing that yes, this IS economic stimulus, including a Brookings Institution study showing the economic value of such funding.
The study, Reducing Unplanned Pregnancies through Medicaid Family Planning Services (PDF) by Melissa S. Kearney and Phillip B. Levine is worth quoting from to further elucidate what's going on here.
First, the abstract, which describes an economic analysis of the very program for which funding is being sacrificed.
Abstract
This brief describes a recent analysis of the impacts of state policies that expanded eligibility for Medicaid family planning services to women who do not meet regular Medicaid eligibility criteria. The results of this research show that these expanded eligibility policies had a significant impact on reducing unplanned births. The effect on birth rates was largest for women ages 18 to 24. Data on individual behavior confirms that this reduction in births was achieved through increased use of contraception among sexually-active women. The authors estimate the policy cost of preventing an unwanted birth to be around $6,800. They conclude that this is a cost-effective policy intervention relative to other policies and programs targeted at reducing teen and unwanted births.
The authors cannot identify a benefit figure they have confidence in, but express confidence that it would exceed $6,800. That seems staggeringly obvious.
Next, from the introduction, a snapshot overview of the problem and program:
Introduction
There is widespread consensus among the American public that rates of teen pregnancy and unintended pregnancies to young, unmarried women are too high. Approximately 30 percent of teenage girls in the United States become pregnant and 20 percent give birth by age 20. Increasingly, policy makers and advocacy groups are recognizing that the high rate of unintended pregnancy among unmarried women in their twenties is also a major social issue. Half of all pregnancies in the United States are reported by the mother as being unintended. More than one-third of these (1.1 million pregnancies in 2001) are to unmarried women in their twenties. The National Campaign to Prevent Teen and Unplanned Pregnancy estimates that these pregnancies accounted for nearly half of the 1.3 million abortions in 2001. Rates of teen pregnancy and unplanned pregnancy are higher among young unmarried women, lower income women, women with lower levels of education, and minority women.
....Twenty-six states since 1993 have been granted waivers by the federal government to expand eligibility for Medicaid coverage of family planning services to women who would not otherwise qualify for the program. We examine the impact of this policy on service take-up, birth rates, sexual activity, and contraceptive use. Our results indicate that expanding eligibility to women at higher levels of income (above the traditional Medicaid eligibility level) reduced overall birth rates among women age 18-19 and 20-24 by 7 percent and 5 percent, respectively. The policy led to a 15 percent decline in births among just those 20-24 year old women made newly eligible for family planning coverage.
Going into more detail about the program:
Medicaid Family Planning Services
Medicaid is currently the largest source of public funding for family planning services in the United States. It funded $1.3 billion in family planning expenditures in 2006, 70.6 percent of total public expenditures. Medicaid family planning expenditures have more than doubled since 1994, with the increase driven largely by the waiver expansion policies described in this brief. The Medicaid program has provided comprehensive access to family planning services to its clients since 1972. But the stringent eligibility requirements to receive Medicaid have meant that in general only mothers who received welfare had access to these services. A series of expansions in the 1980s extended Medicaid eligibility for pregnancy-related care to childless women who met state income eligibility requirements; these services include family planning services for 60 days post-partum.
Since the early 1990s, the federal government has granted states waivers to provide coverage of family planning services to women who do not otherwise qualify for Medicaid. All such waivers require states to offer the full range of family planning services it offers to its regular Medicaid recipients to the additional population targeted. States have implemented their waiver policies in different ways, but the expanded services have generally applied to the following groups of women: (1) women whose pregnancy-related care, including post-partum family planning, would otherwise expire; (2) women who would lose their Medicaid eligibility status for any reason; and (3) women whose income is below a specified income threshold (typically 185% or 200% of the federal poverty threshold), but above the eligibility threshold for the state's regular Medicaid program, regardless of whether they meet the categorical requirement of having a child or being pregnant. Waiver policies that extend eligibility to this third group are the most far-reaching in terms of potential population affected.
Rather than a waiver system, the stimulus bill funding would have extended funding to all states at a time when state budget shortages are virtually universal, particularly Medicare funding. Without the guaranteed assurance that this money will be forthcoming, it is highly likely that these programs will not be budgeted for by states, many of which need to know what federal funds will be available by Presidents' Day, according to a legislative specialist at the National Conference of State Legislatures.
Following their analysis, the authors conclude:
Conclusion
Our research shows that expanding Medicaid family planning coverage to women at higher levels of income has had a significant impact on reducing unplanned births. Increased use of contraception appears to explain the decline. We estimate that the cost of preventing an unwanted birth is around $6,800. Based on our reading of the evidence regarding the effectiveness of other interventions designed to reduce unwanted births, this seems like a relatively cost-effective policy intervention.
Beyond the cost-effectiveness of this policy, our results also raise the possibility that family planning waivers may have improved women's outcomes more broadly. If women are better able to control their fertility, new life options may present themselves. For instance, educational attainment and labor market outcomes might improve for women who delay childbearing or have fewer children. Future research should explore this issue.
In a diary at Hullabaloo, Post-Partisan Pain, dealing with the inclusion of ineffectual tax cuts, as well as the exclusion of mortgage bankruptcy reform and contraceptive funding, dday writes:
The report is that Obama personally called Henry Waxman, who has jurisdiction over the provision, and told him to ditch it. So now we're listening to Republicans who have no imagination and don't understand the economy. Family planning is a demand-based service that requires staffing. That means jobs. Jobs that now won't be created or will be eliminated by the states because it makes Republicans feel icky.
Then there's the mortgage provisions which Democrats would like to put in the stimulus bill that would allow homeowners to get their principle reduced by a bankruptcy judge, but which Obama wants out of it because big business and their Republican puppets might get mad at him. And once again, the President is prevailing....
The stimulus isn't a horrible bill, and there's a lot to like in there, particularly in the energy and health care provisions. But it's certainly Chamber of Commerce-friendly at a time when their member organizations are laying off tens of thousands. Obama has maintained this sugar plum fairy vision of bipartisanship, yet his bill manifestly does NOT value "what works" over ideology. Quite the opposite. It makes room for ideology, conservative ideology, and pre-empts provisions that would work much better in bringing back the economy. Despite a mandate for major new social and economic programs from the public, Obama is still playing small ball. He's responding to Republican hissy fits and teaching them that all they have to do to wring a concession is scream for a day or so and let their media allies whip up a frenzy. He's offering half-measures when they won't do the job.
If this bill is a blueprint for the next four years, it's going to be a missed opportunity. Also painful.
Oh, and that mandate dday mentioned? He links to the Center for American Progress, which generated the following charts from a WaPo/ABC poll I mentioned the weekend before the inauguration:
Instead of bringing us the full-throated change the American people are ready for--including, rather obviously a good chunk of independents and Republicans, Obama is tethering himself to the failed policies of the past in ludicrous charade with figures who are political powerless, except for the power which he is giving them.
Let's review. Obama says he wants to ignore labels and just do "what works". But the GOP positions he's adopted--including business tax cuts in place of transit funding, excluding mortgage bankruptcy reform, and excluding funding for contraceptives--do not work. He is blatantly violating his campaign pledge, in order to make it appear as if the GOP is being reasonable, rational, pragmatic, and solution-oriented, when they are not. And he is making Democrats appear ideologically rigid, when they are the ones who are actually being reasonable, rational, pragmatic, and solution-oriented.
There are four courses of action that Obama could have pursued:
(1) Insisted on solutions that work, and rejected the GOP "solutions" right out front, explaining why they don't work.
(2) Insisted on solutions that work, and welcomed a fact-based debate, using his bully pulpit to make sure that the entire nation came to understand that the GOP "solutions" don't work, before rejected them.
(3) Insisted on solutions that work, and welcomed a fact-based debate, letting 1-day Congressional committee hearings clearly establish that the GOP "solutions" don't work, then using his bully pulpit to explain what just happened, and to make sure that the entire nation came to understand that the GOP "solutions" don't work.
(4) Continue using the rhetoric of seeking to do "what works" and falsely adopting failed GOP policies under that rubric.
Any one of #s 1, 2 or 3 would have kept his campaign promise, and would have been acceptable to me. Instead, he did #4. And, indeed, this is what I've been warning would happen with him all along. He is using his framing of "what works" to restore legitimacy to a failed ideology and its failed policies, while undermining and opposing the policies and positions of those who supported him, policies and positions that work.
This is not "change we can believe in." This is just more of the same brain-dead Dick Morris triangulation BS, acting as if the last election was 1994, not 2008. One can call it "the higher Clintonism", perhaps, because it transforms political compromise on bad terms from a survival strategy into a matter of high principle.
The sooner we recognize it for what it is, and reject it, the better for all concerned.
Not least of all, Barack Obama. |
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