Opinion: Preserving the Integrity of Md.’s Reproductive Health Care System

The Trump administration is coordinating a devastating political assault on reproductive health care intended to limit access to birth control, target vulnerable communities, defund Planned Parenthood, ban abortion and overturn Roe v. Wade.

In Maryland, stakeholders, elected officials and community activists have been preparing for this moment for a generation. The legislature, working with policymakers, have crafted a statewide reproductive health care system that should serve as a model for the nation.

The rash of extreme abortion bans sweeping the country have a single goal in mind: overturn Roe v. Wade. Fortunately for Marylanders, a 1991 state law will protect a women’s right to an abortion despite what might happen on the federal level.

In 1998, Maryland became the first state in the nation to mandate health insurance coverage for birth control. Today, Marylanders enjoy the country’s most expansive and comprehensive reproductive health insurance coverage available anywhere. Everyone is entitled to affordable reproductive health care from the provider of their choice, regardless of their ability to pay or their insurance coverage.

Lawmakers have spent the better part of the past decade expanding services and reducing barriers and as a result Maryland is ahead of the curve. For example, most contraception is available without a co-pay including vasectomies and Plan B; a 12-month supply of birth control pills can be picked up at one time; and beginning this year Maryland pharmacists are able to prescribe birth control.

For the past 50 years the federal government has partnered with the states to provide patient-centered, affordable health care for low-income, young and uninsured individuals under the program called Title X. But as part of a strategy to hurt Planned Parenthood the Trump administration implemented a gag rule that prohibits health care providers and physicians from providing medically accurate information on the full range of reproductive health services, including abortion. Because of this terrible change in policy, Planned Parenthood withdrew from the Title X program.

Does it come as any surprise that the Trump administration is targeting those most vulnerable among us? Title X patients are disproportionately low-income and young; about one-third identify as people of color, and about one in 10 have limited English proficiency.

People with means will continue to have access to all levels of care whereas people with low incomes will have little to no access to care.

At a time in our nation’s history when we already struggle to provide equitable health services, especially to marginalized communities of color, these mean-spirited policy changes will create a system of substandard care and will have a negative impact on health outcomes for the people who need health care the most.

Preparing for this potential outcome, Maryland passed legislation that ensures continued funding for all Title X services, replacing $3.2 million in federal dollars with state money, providing equity and access to reproductive care, regardless of the ability to pay. Due to these protections, more than 75,000 Marylanders will continue to receive free or discounted family planning services at either a Planned Parenthood clinic or a local community health center. This is vital because approximately 60 percent of patients who go to a publicly funded family planning center consider it to be their primary source of health care.

These terrible policy changes are causing confusion among people everywhere. We are working hard to reassure patients that all services will continue to be available at our Planned Parenthood clinics.

Title X services include pregnancy testing; contraceptive counseling and services; pelvic exams; screening and treatment for sexually transmitted diseases; screening for cervical and breast cancer, high blood pressure, anemia, diabetes and HIV/AIDS; infertility services; health education; and referrals for health and social services.

Rather than cutting these services we should be expanding health care. There is so much more to do to reduce barriers to health care, improve health outcomes and expand access to birth control, but here in Maryland we can be proud that our elected officials consistently support policy that keeps high quality reproductive care affordable and accessible for everyone.

At Planned Parenthood our goal is to preserve the integrity of Maryland’s reproductive health care system, but we cannot rest on our laurels. Improving health outcomes for women, especially women of color, is an ongoing challenge in Maryland. A challenge that we must face head on and win.

If the federal government refuses to participate in this effort we will go it alone, but we look forward to the day when we can once again partner with the US government to advance contraception and family planning.

— KAREN J. NELSON

The writer is president and CEO of Planned Parenthood of Maryland. Her email is [email protected].

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