A Republican state lawmaker is pitching an idea he says would lower health-care costs and lead to fewer abortions through a program that would have the state and federal governments paying for birth control for low-income Utah women.
The concept has proven results: giving women greater say over when they have children, lowering the birth rate and saving money through programs that are covered largely by federal taxpayers.
Rep. Ray Ward, of Bountiful, said during an informal hearing on Tuesday that his proposal, if passed when the Legislature meets in January, would bring women out of poverty by drastically reducing their chances of becoming pregnant before they choose.
“There was a time 20 or 30 years ago when a larger number of people felt that birth control was perhaps suspect,” Ward, a family physician, told the Women in the Economy Commission, a group of leaders from the Legislature, state agencies and businesses.
“We’re not a few years but a few decades past where the average person in our Utah population feels that way,” he said.
The draft bill has been pitched as a way to give thousands of women control over when they have children and allow them to continue work or education before considering starting families. Its proponents say it will prevent unwanted pregnancies and hundreds of abortions.
States that expanded access to birth control have seen pregnancy and abortion rates decline. Colorado saved nearly $70 million in state and federal money and cut teen abortion rates in half in five years by providing 36,000 low-income women long-acting birth control, according to the Colorado Department of Public Health and Environment.
Ward said his concept would save an estimated $9 million during a four-year pilot of the program and provide long-acting birth control to about 8,000 women. The federal government would pay for 90 percent of the cost of expansion, which isn’t a part of the Affordable Care Act that Republicans in Congress have unsuccessfully tried to eliminate.
“[It] does not have anything to do with the Affordable Care Act,” Ward said. It “doesn’t stand or fall” if the program known as Obamacare is repealed.
The expansion would cover women not eligible for Medicaid who earn up to 95 percent of the federal poverty level, or about $11,500 in 2017 for a single woman. After four years, the program would expire unless legislators extended it.
Gov. Gary Herbert included the idea in his 2017 recommended budget, but the concept failed to gain any traction. Ward said he hopes legislators on budget writing committees would see the concept as good fiscal policy.
“At some point you have to prioritize something that can make your situation better in the long run,” Ward said.
Women who pay out of pocket can spend up to $1,200 for long-acting and reversible contraceptives, such as intrauterine devices (IUDs) or implants, which would be covered under the bill.
Ann Marie Wallace, a member of the commission, noted that “there are inherent risks for using IUD and also implants.”
“Is there any significant amount of cost with risks that come with using those contraceptives and if they have any impact significantly at all with the savings or costs?”
David Turnok, an obstetrician and gynecologist who has worked on a similar pilot program through Salt Lake County, said the possible side effects or complications from birth control are far outweighed by complications more regularly experienced during pregnancy.
“We have so much data on the safety and efficacy of these methods,” Turnok said.
Despite evidence of savings and other positive outcomes, the proposal could face critics among small-government groups.
“Medicaid expansion is not something I’ve been supportive of,” said Gayle Ruzicka, president of the Utah Eagle Forum and one of the most active lobbyists on Capitol Hill, who noted she hasn’t yet studied the proposal. “[Medicaid] has not worked out in the long run. We have serious problems with health care.”
Ward noted questions about complications from contraceptives are one of two concerns legislators and others may have for his proposal this year. The other, he said, was the roughly $1 million annual startup cost before the program is expected to become revenue neutral in its second year and, eventually, save money.
Cost is a concern for Rep. Karianne Lisonbee, a Clearfield Republican who sits on the Health and Human Services Interim Committee. But she’s open to the concept.
“The committee members in general would like to see unwanted pregnancies prevented in that way,” she said, “rather than through abortion or other means.”
Ward said it’s time to implement the program, as Utah remains one of seven states not to expand Medicaid to cover family planning.
If most other states, including the “Republican, ruby red South,” could expand access to birth control, Ward said, “We can figure out a way to implement this.”