Texas Exceeds U.S. on Rate and Cost of Unintended Pregnancies

As the clock ticks down on federal support of the Women’s Health Program, a Guttmacher Institute analysis underscores how high the stakes are for Texas.

The state said it is ready to take over the program from the federal government, which will cease to fund it with Medicaid dollars Monday. Texas lost a final legal effort to force the federal government to continue to fund the program when a Waco judge denied the state’s request for a permanent injunction.

Texas wanted to exclude Planned Parenthood from state funding because a separate arm of the organization uses private funds to provide abortion services. While Planned Parenthood and Women’s Health Program providers offer a wide array of health services to low-income women, publicly funded contraceptive services specifically have strong political and religious opponents.

According to Guttmacher, Texas women have a higher rate of unintended pregnancies, spend more government funding on those pregnancies, and the state’s publicly funded family planning—of which Planned Parenthood is a major source—met only one-third of the demand.

Economically disadvantaged women, who are the most likely to use publicly funded family planning, are disproportionately affected by unintended pregnancies. In 2006, the unintended pregnancy rate among women with incomes lower than the federal poverty level, at 132 per 1,000, was more than five times as high as the rate among women with incomes greater than 200 percent of poverty, according to Guttmacher. The 2 out of 3 U.S. women at risk of unintended pregnancy who use contraceptives consistently account for only 5 percent of unintended pregnancies. All others are attributable to the 1 out of 3 women who either do not use contraceptives or use them inconsistently.

The state has contended that it is prepared to handle the program’s caseload. However, according to a Morning News analysis, 222 providers had been approved by October in Dallas, Denton, Collin and Tarrant counties to treat about 13,000 women in the program, more than half of whom did not have program clients previously. They would also have to handle about 4,300 new patients that previously had used Planned Parenthood. The analysis indicated the provider network might not be adequate to handle the additional caseload.

According to Guttmacher:

  • Unintended pregnancy: 53 percent of pregnancies in Texas were unintended, compared with 49 percent, in 2006.
  • Teen pregnancy: The Texas rate in 2005 was 88 per 1,000, compared with the U.S. rate of 70 per 1,000. Most of those were unintended.
  • Public funding: About 3 out of 4 Texas unintended pregnancies were publicly funded, compared with about 2 out of 3 elsewhere in the U.S in 2006. The public tab in that year was $1.3 billion in Texas, of which the state spent 39 percent.  Each Texas unintended pregnancy cost $257 in public funds, compared with $180 nationally.
  • Averted pregnancies:  Texas family planning centers prevented an estimated 98,700 pregnancies in 2008, of which 43,900 would have been births and 41,200 would have been abortions.

Steve Jacob is editor of D Healthcare Daily and author of the new book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at steve.jacob@dmagazine.com.


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