Access to Health Clinics and Medicaid Births

Cutting Planned Parenthood would increase Medicaid births, C.B.O. says, By Kate Zernike, March 14, 2017, New York Times: “Cutting off federal funding for Planned Parenthood — a longstanding conservative goal that is included in the Republican bill to replace the Affordable Care Act — would reduce access to birth control for many women and result in thousands of additional Medicaid births, according to the Congressional Budget Office.  Because nearly half of all births nationwide are to Medicaid patients, and many of those babies are Medicaid patients themselves, the budget office estimated that defunding Planned Parenthood even for a year would increase Medicaid spending by $21 million in the first year, and $77 million by 2026…”

Childbearing Trends

3 charts that show America’s poverty problems start at birth, By Danielle Kurtzelben, July 9, 2014, Vox: “A new Census report confirms a few longstanding childbearing trends: women are having children more and more outside of marriage, and more educated women tend to have children later. But it also shows something more surprising: the share of children born into poverty is large, and it may be getting worse. In 2012, more than one in four women having kids — nearly 28 percent — were living in poverty that year. That’s up markedly from 2008, when the share was only 25 percent. By comparison, only around 15 percent of Americans were in poverty altogether that year. . .”

LA Times Series on the World’s Population

Beyond 7 billion, series homepage, By Kenneth R. Weiss, Los Angeles Times: “After remaining stable for most of human history, the world’s population has exploded over the last two centuries. The boom is not over: The biggest generation in history is just entering its childbearing years. The coming wave will reshape the planet, and the impact will be greatest in the poorest, most unstable countries…”

Teenage Pregnancy

Teenage pregnancy: High US rates due to poverty, not promiscuity, By Stephanie Hanes, May 22, 2012, Christian Science Monitor: “Why is a teenage girl in Mississippi four times as likely to give birth than a teenage girl in New Hampshire? (And 15 times more likely to give birth than a teen in Switzerland?) Or why is the teen birth rate in Massachusetts 19.6 per 1,000, while it’s 47.7 per 1,000 in Washington, D.C.? And why, despite a 40 percent drop over two decades, are teen moms still far more common in the US than elsewhere across the developed world? (And nope, it’s not that American teens have more sex. Many studies have found that US teenagers have less sex than compatriots in Europe.) The answer, according to a study published today in the Journal of Economic Perspectives, may well lie in social inequality…”

Teen Birthrates in the US

  • Birthrate for U.S. teens is lowest in history, By Sharon Jayson, April 9, 2012, USA Today: “Teen births are at their lowest level in almost 70 years, federal data report today. Birthrates for ages 15-19 in all racial and ethnic groups are lower than ever reported. ‘Young people are being more careful,’ says Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy. She attributes the declines to less sex and increased use of contraception.  The report by the National Center for Health Statistics says the actual number of teen births in 2010 was the lowest since 1946. It credits ‘strong pregnancy prevention messages’ and says contraceptive use ‘may have contributed.’ The analysis comes at a time when contraception is a hot political debate, from a congressional investigation of whether federal money pays for abortions to concern among some church leaders over an Obama administration mandate that all health insurance cover birth control…”
  • Teen births hit new low as pregnancy prevention programs pay off, By Michael Muskal, April 10, 2012, Chicago Tribune: “Teen births have fallen to record lows in the United States, continuing an overall trend — partly due to programs aimed at preventing pregnancies among teenagers, the federal Centers for Disease Control and Prevention reported on Tuesday. The U.S. teen birth rate declined 9% from 2009 to 2010, reaching 34.3 births per 1,000 women ages 15-19, the CDC reported. From 1991 through 2010, the rate dropped by 44%. Teen child-bearing has been generally on a long-term decline in the United States since the late 1950s, but the United States continues to have one of the highest such rates among industrialized countries. Teen mothers and their offspring have more health risks than older women and their offspring, adding about $10.9 billion to public health costs each year, the agency said…”

US Teen Pregnancy Rate

  • Teen pregnancy rate hits 40-year low, By Joel Provano, February 8, 2012, Atlanta Journal-Constitution: “The U.S. teen pregnancy rate has reached a 40-year low, a new study finds. The study, by the Guttmacher Institute, found that the pregnancy rate declined 42 percent from its peak in 1990, according to the study released Wednesday. The teen pregnancy rate in 2008 was 68 per 1,000 girls age 15-19, down from 117 per 1,000 in 1990. That means about 7 percent of girls in that age group became pregnant that year. In addition, the survey showed the birthrate declined 35 percent between 1991 and 2008, from 61.8 to 40.2 births per 1,000 teens…”
  • Teen pregnancy, abortion rates at record low, study says, By James B. Kelleher, February 8, 2012, Chicago Tribune: “Birth and abortion rates among U.S. teens fell to record lows in 2008 as increased use of contraceptives sent the overall teen pregnancy rate to its lowest level since at least 1972, a study showed on Wednesday. But disparities among racial and ethnic groups continued to persist, with black and Hispanic teens experiencing pregnancy and abortion rates two to four times higher than their white peers, the Guttmacher Institute, the nonprofit sexual health research group that conducted the analysis, said…”

Teen Pregnancy

  • U.S. teen pregnancy rate remains highest in developed world, By Shari Roan, January 19, 2012, Los Angeles Times: “Teen pregnancy rates in the United States have fallen in recent years, but the country still has a higher rate than any other developed country, according to data released Thursday from the Centers for Disease Control and Prevention. Battles over how to best prevent teen pregnancy may be to blame for the continued high rate in the United States. Abstinence-only programs are favored in some areas while education and improved access to contraception are supported in others. The most recent controversy stemmed from the federal government’s refusal in December to allow emergency contraceptive pills to be sold over-the-counter to girls age 16 and younger…”
  • CDC: Many teen moms didn’t think it could happen, By Mike Stobbe (AP), January 19, 2012, San Francisco Chronicle: “A new government study suggests a lot of teenage girls are clueless about their chances of getting pregnant. In a survey of thousands of teenage mothers who had unintended pregnancies, about a third who didn’t use birth control said the reason was they didn’t believe they could pregnant. Why they thought that isn’t clear. The Centers for Disease Control and Prevention survey didn’t ask teens to explain. But other researchers have talked to teen moms who believed they couldn’t get pregnant the first time they had sex, didn’t think they could get pregnant at that time of the month or thought they were sterile…”
  • Roanoke’s teen pregnancy rate plunges 32%, By Courtney Cutright, January 20, 2012, Roanoke Times: “Roanoke’s rate of teen pregnancies dropped nearly 32 percent from 2009 to 2010, moving the city out of the top 10 localities in Virginia with the highest rates. Roanoke still ranks 12th in the state. But the city’s teen pregnancy rate for 2010 is one of the lowest since 1996, according to Virginia Department of Health statistics posted online recently…”

US Teen Birthrate

Why the US teen birthrate hit a record low in 2010, By Jennifer Skalka Tulumello, December 12, 2011, Christian Science Monitor: “Increased use of birth control, and, some say, other wide-ranging variables such as abstinence-only education and a poor economy, are playing key roles in driving the US teen birthrate to a record low, according to new data from the Centers for Disease Control and Prevention. The CDC’s National Center for Health Statistics reported in November that the rate declined 9 percent from 2009 to 2010, with 34.3 births per 1,000 teens ages 15 to 19. That marks the largest single-year drop since 1946-47 – and the lowest level ever reported in the United States. Teenage birthrates have tracked a relatively steady downward trend since 1991, when the rate was 61.8 births per 1,000 teens. (The rates were 52.2 in 1981, 64.5 in 1971, and 88.6 in 1961.)…”

Unintended Pregnancies and Income

Unintended pregnancy rate rises among poor women, study says, By Shari Roan, August 24, 2011, Los Angeles Times: “Unintended pregnancies make up almost half of all pregnancies in the U.S. But a new study shows that rates are rising among poor women and declining among women with adequate economic resources. The report, released Wednesday by researchers at the Guttmacher Institute, reviews data from 1994 through 2006. The unintended pregnancy rate among women with incomes below the poverty line rose 50% in that time period. Among higher-income women, the rate fell 29%…”

Maternal and Infant Well-Being – Michigan

  • Michigan’s sharp rise in births to unwed moms means ‘a lot more children growing up in poverty’, By Sue Thoms, July 7, 2011, Grand Rapids Press: “A sharp increase in the number of unmarried women having babies means trouble ahead for mothers and children in Michigan, according to the Michigan League for Human Services. ‘We’re going to see a lot more children growing up in poverty,’ said Jane Zehnder-Merrill, director of a report released Wednesday on trends in maternal and infant health from 2000 to 2009. The study found 40 percent of births in Michigan in 2009 were to unmarried woman — a 20 percent rise since 2000. Two of every three births to women in their early 20s were to unwed mothers…”
  • Study: Fewer teens, more singles giving birth in Michigan, By Chris Christoff, July 7, 2011, Detroit Free Press: “The percentage of babies born in Michigan to unmarried mothers rose significantly during the last decade, but fewer teens are giving birth, a new study shows. About half of all births in 2000-09 were to low-income mothers eligible for Medicaid health insurance, according to the Kids Count in Michigan report by the Michigan League for Human Services. The trend is troubling because babies born to unmarried women are more likely to live in poverty and have health and learning problems, said Kids Count in Michigan Director Jane Zehnder-Merrell…”

States and Medicaid Changes – Indiana, Arizona

  • Indiana law to cut Planned Parenthood funding is blocked, By Robert Pear, June 24, 2011, New York Times: “A federal judge ruled Friday that the State of Indiana could not cut off money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The judge, Tanya Walton Pratt of the Federal District Court in Indianapolis, blocked provisions of a new state law that penalized Planned Parenthood because some of its clinics performed abortions. The law, she said, conflicts with the federal Medicaid statute, which generally allows Medicaid beneficiaries to choose their health care providers. Planned Parenthood provides services other than abortion, including family planning and screenings for cancer and sexually transmitted diseases. In issuing a preliminary injunction late Friday, Judge Pratt said the state law ‘will exact a devastating financial toll on Planned Parenthood of Indiana and hinder its ability to continue serving patients’ general health needs…'”
  • Arizona Medicaid: New attempt made to block cuts, By Mary K. Reinhart, June 28, 2011, Arizona Republic: “Attorneys for low-income Arizonans filed a motion in Maricopa County Superior Court on Monday to stop sweeping cuts to the state’s Medicaid program from taking effect Friday. It may be the last chance for more than 135,000 people expected to lose coverage in the coming year under the Arizona Health Care Cost Containment System, which Gov. Jan Brewer and state lawmakers cut by more than $500 million to balance the budget. Attorneys for three public-interest groups argue that Brewer and lawmakers are violating the state Constitution and the will of voters, who in 2000 agreed to expand AHCCCS and extend health care to everyone earning less than the federal poverty level. The Arizona Supreme Court last Friday declined to accept a similar case, without explanation…”

State Medicaid Programs

  • State, feds square off in Medicaid battle, By Heather Gillers, June 5, 2011, Indianapolis Star: “Before he signed a bill cutting Planned Parenthood’s Medicaid funding last month, Gov. Mitch Daniels said the group could keep the funds if it gave up providing abortions. If Planned Parenthood wanted Medicaid money, in other words, it would have to play by Indiana’s rules. Then, the federal government turned the tables. Federal Medicaid officials rejected Indiana’s Medicaid plan because its provision to strip funding from Planned Parenthood violates federal law. If Indiana wants Medicaid money, the federal government said, the state would have to play by federal rules…”
  • New Jersey seeks to shrink Medicaid, By Joel Rose, June 7, 2011, National Public Radio: “Cash-strapped states are rethinking how much health care coverage they can afford to provide for their neediest residents. New Jersey Gov. Chris Christie wants to cut $500 million in Medicaid spending – in part by freezing more than 20,000 state residents out of the program. Critics say the cuts would hurt those who can least afford it. For years, New Jersey expanded health care coverage for low-income residents – people like Deborah Shupenko of Passaic. But last month, after 10 years of state-funded health insurance, Shupenko got a letter in the mail…”
  • More Medicaid cuts on way: Payments to doctors will be reduced; some visits to cost patients $1 more, By Renee Dudley, June 7, 2011, Charleston Post and Courier: “Medicaid payments to doctors will be reduced by up to 7 percent and patient co-payments for some doctor visits will increase by $1 as the South Carolina Medicaid agency cuts an estimated $125 million in state costs for the fiscal year that begins next month, agency officials announced Monday. Beginning July 1, patient co-pays will increase from $2.30 to $3.30 — the maximum amount allowed by federal law — for doctor, clinic, home health and optometrist visits. And for the first time, people enrolled in some programs for the elderly and disabled will be required to make co-pays for some medical services. Starting July 8, Medicaid reimbursement rates to doctors, dentists and most hospitals will be cut for the second time in three months…”

Medicaid Funding – Indiana

U.S. says new Indiana law improperly limits Medicaid, By Robert Pear, June 1, 2011, New York Times: “The Obama administration prohibited the State of Indiana on Wednesday from carrying out a new state law that cuts off money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The state law penalized Planned Parenthood because some of its clinics also perform abortions. Dr. Donald M. Berwick, administrator of the federal Centers for Medicare and Medicaid Services, said the state law imposed impermissible restrictions on the freedom of Medicaid beneficiaries to choose health care providers. The freedom of choice, he said, is generally guaranteed by the federal Medicaid law. But state officials said Wednesday that they intended to continue enforcing the state law, which took effect on May 10, when it was signed by Gov. Mitch Daniels, a Republican…”

State Medicaid Programs

  • GOP: Feds should let states tighten Medicaid eligibility, By Mary Agnes Carey and Phil Galewitz, May 24, 2011, Miami Herald: “With their proposal to turn Medicaid into block grants all but dead, Republicans are pushing legislation to let states tighten eligibility rules for the health program for poor people and those with disabilities. The move, which would affect Medicaid as well as the Children’s Health Insurance Program, would help cash-strapped states save money, but it also could cause hundreds of thousands of people to lose health coverage. While Democrats strenuously oppose the proposed Medicaid change, some advocates and physicians groups worry that the issue could wind up as a bargaining chip in the partisan wrangling over raising the federal debt limit and reducing the budget deficit…”
  • Christie eyes curb on Medicaid rolls, By Matt Katz and Maya Rao, May 23, 2011, Philadelphia Inquirer: “Gov. Christie plans to seek approval for a proposal that would deny Medicaid coverage to adults in a family of four with an annual household income of little more than $6,000, down from the current $30,000. A single mother raising three children who earned as little as $118 a week would not qualify for the government-funded medical coverage. The eligibility-requirement change, which must be cleared by the Obama administration and would apply only to new adult Medicaid applicants, would follow Christie’s eliminating – for the second year – a long-standing line item that would provide nearly $7.5 million in funding to family-planning clinics…”
  • State drops managed-care Medicaid plan for 5 counties, By Charles S. Johnson, May 23, 2011, Billings Gazette: “The Schweitzer administration has abandoned its controversial plan to set up a Medicaid managed-care demonstration project in Lewis and Clark, Cascade, Choteau, Teton and Judith Basin counties. The Gazette State Bureau reported last fall that the Schweitzer administration since August 2009 had discussed using managed-card Medicaid, the state-federal program that provides health care for the poor and disabled. One major proposal came from Centene Corp., a large managed-care firm based in St. Louis. It was based on the idea that the private company would be paid a certain amount of money for each patient and ‘manage’ that patient’s care by directing him or her to lower-cost health care. That, in turn, was supposed to save money for both the state and the company.
    By last week, the state pulled the plug on the idea…”
  • U.S. objects to new law on clinics in Indiana, By Robert Pear, May 22, 2011, New York Times: “The Obama administration is raising serious objections to a new Indiana law that cuts off state and federal money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The objections set the stage for a clash between the White House and Gov. Mitch Daniels, a Republican, over an issue that ignites passions in both parties. The changes in Indiana are subject to federal review and approval, and administration officials have made it clear they will not approve the changes in the form adopted by the state. Federal officials have 90 days to act but may feel pressure to act sooner because Indiana is already enforcing its law, which took effect on May 10, and because legislators in other states are working on similar measures…”

Abortion Rates and Poverty

Abortion rates decline overall, increasing in poor, By Sharon Jayson, May 23, 2011, USA Today: “Abortion rates fell among most groups of women between 2000 and 2008, except for those classified as poor, finds an analysis conducted by the nonprofit Guttmacher Institute and published online today in the journal Obstetrics & Gynecology. Guttmacher, which has been tracking abortion since 1974, found that the abortion rate for low-income women increased 18% during the same period that the national rate dropped 8%. Low-income women (as an example, those earning $17,170 or less in a three-person household) accounted for 514,040 abortions, or 42% of all abortions, in 2008. The abortion rate for the poor rose from 44.4 abortions per 1,000 women ages 15-44 in 2000 to 52.2 in 2008. At the same time, the 2008 national abortion rate was 19.6 per 1,000, which dropped 8% from a rate of 21.3 in 2000. Sociologist Carole Joffe of the Bixby Center for Global Reproductive Health at the University of California, San Francisco, says the report re-affirms demographic trends…”