Upside-down family planning in Maryland

Services are only available after a baby is born, but a small investment can fix this absurdity

March 25, 2010|By Heather R. Mizeur and Catherine Pugh

"It's not economical to go to bed early to save candles -- if the result is twins."

Improbably, this ancient Chinese proverb holds an important recommendation for Maryland's budget today. Currently, our state offers low-to-moderate-income pregnant women extensive health care coverage through our Maryland Medical Assistance Program. We also make comprehensive family planning services available for these same women -- but only after they have already given birth.

That's right: Maryland only offers family planning for women who have already started a family.

It doesn't take a Nobel Prize-winning economist to recognize the folly here, and so we introduced the Family Planning Works Act to bring a little common sense to these line items in Maryland's budget. It's a simple piece of legislation that would make women eligible for no-cost family planning services based solely on their income. Single women would qualify if they earned up to about $27,000 per year.

Good family planning services -- including counseling on family planning methods, gynecological care, breast exams, pregnancy tests and contraception -- are highly effective at reducing unintended pregnancies and abortions, which, in turn, would mean significant savings in the pregnancy-related care that the state is paying for now. When young women make responsible decisions about having a family, they live healthier, more productive lives, and so do their children. It's an investment that saves money now -- and even more later. And the federal government is willing to fund 90 cents of every dollar we spend.

After a modest $2.3 million in start-up funding, our state could save as much as $22 million a year while helping thousands of young women delay childbearing until they're better able to provide for their kids. We could easily save $176 million or more in the first 10 years alone -- a financial return 75 times the initial investment!

No business or investor would pass up that kind of opportunity. They would be crazy to do so, and we would be equally foolish to pass up this opportunity on behalf of Maryland's taxpayers and the women and families that would be helped.

We know how difficult it will be to find $2.3 million for seed money. Here are a few suggestions:

• Budget cuts. Cutting more money out of an already lean budget won't be easy, but the savings we could achieve are worth the effort. $2.3 million could be saved by reducing University System of Maryland staff travel for one year by just 4.2 percent, or cutting 1.6 percent from the office budgets of each Maryland department secretary.

• Untapped federal funding. Maryland has recently improved outreach and enrollment for its child health insurance program, and our success likely qualifies us for a $15 million federal grant rewarding state efforts. If we're successful, $2.3 million could be set aside as start-up funding.

• Temporary tax increases. Many health care advocates have been pushing an increase in the alcohol tax this session to fund vital health care services. We might allocate $2.3 million from this additional revenue, or we could temporarily raise the alcohol tax by 2 cents per gallon -- the equivalent of less than two-tenths of a cent per beer.

We could also temporarily apply our sales tax to hair cuts, tanning or even parking lots, each of which would raise more revenue than would be needed to get this policy launched.

• Private foundation funding. If we somehow end up empty-handed looking within our own budget, Maryland is able to accept private foundation funds to begin this initiative.

Our choice remains clear no matter how we pay for it. On the one hand, we can maintain the indefensible status quo. On the other, we can expand access to vital health care services, help thousands of young women live better and healthier lives, enhance the chances of success for their families and children, and save our state money year after year. Family planning works, and so would this legislation.

The Chinese proverb warned against the misguided wisdom of short-term savings that bring long-term costs. Let's not make the mistake of saving candles when we could be saving money and improving lives.

Del. Heather R. Mizeur (heather.mizeurƒo@house.state.md.us) is the lead sponsor of HB 1358. She represents Takoma Park and Silver Spring. Sen. Catherine Pughƒo (catherine.pugh@senate.state.md.us) is the lead sponsor of the Senate companion bill (SB 521). She represents Baltimore. Both are Democrats.

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