Funding Birth Control? It’s the Economy, Stupid

The $825 billion economic stimulus package is finally taking shape as House committees finalize their contributions to the bill. The good news is that healthcare spending will be a major part of the stimulus: $87 billion has been set aside to help states pay for Medicaid alone. But one health-related provision was sacrificed to political expediency on Tuesday in an attempt to wrangle Republican support for the stimulus package: Medicaid expansion for birth control. Medicaid is already the single largest source of public funding for family planning nationwide, according to the Guttmacher Institute. The stimulus provision would have made it easier for states to cover family planning for low-income women who currently make slightly too much to qualify for regular Medicaid. House Minority Leader John Boehner made political hay out of the provision, claiming that Dems were sneaking in millions for birth control for reasons that had nothing to do with stimulating the economy. He's dead wrong, as Cory Richards points out at RH Reality Check: Healthcare spending is a tried and true method of economic stimulus and the current bill sets aside billions of dollars for that purpose. The idea that birth control coverage is less important than any other kind of healthcare spending is absurd. Reproductive rights activists pushed hard for the provision because they believe it would give more women access to family planning. By law, when states cover birth control through Medicaid, the federal government covers 90% of the cost. The birth control expansion would simply have simply made it easier for states to relax the eligibility criteria to cover more women. Providing more services, to more people, with more money supplied by the federal government is textbook economic stimulus. On Tuesday, President Barack Obama begged House Energy and Commerce Committee Chair Henry Waxman to strike the birth control proviso. The expansion didn't have a chance. By late afternoon, TPMDC was reporting that birth control was gone from the House bill and that the Senate Dems had signaled that it wasn't coming back in their stimulus bill. Jodi Jacobson of RH Reality pegs the political dynamic as a farce in four acts: Democrats use their majorities to advance some popular policy, Republicans freak out, Democrats capitulate, elite pundits congratulate Democrats for shooting themselves in the foot with such grace and aplomb. In the American Prospect, Nick Beaudrot notes that Obama is unlikely to win any Republican votes by striking birth control from the stimulus. Elsewhere, writers were wrestling with other health-related issues. Simon Maxwell Apter in the Nation argues that the time has come to recognize PTSD as a legitimate combat injury and award Purple Hearts accordingly. But Debra Dickerson of Mother Jones counters that the Purple Heart should be reserved for combat-related injuries. Dickerson's rejoinder seems to beg the question: If someone gets PTSD from serving in a combat zone, is it a combat injury? And if so, why doesn't this sacrifice merit a Purple Heart? In the Nation Sarah Arnold argues that New York's draconian Rockefeller drug laws are ripe for reform. Arnold argues that a perfect storm for drug reform might be brewing in the Empire State: Democratic governor, Democratic control of both statehouses, and a financial crisis that makes locking up drug offenders prohibitively expensive. In the American Prospect, public health scholar Harold Pollack examines our society's worst drug problem: alcoholism. He argues that our society focuses too much attention on treating alcoholism once it sets in and not enough on crafting public policies, such as legal drinking ages and liquor tax rates, to help prevent problem drinking. The birth control stimulus skirmish marks a new twist in Obama's relationship with women's groups and reproductive rights activists. Last week, the new president elated women's health groups by freezing Bush's last-minute anti-abortion rules and reversing the Global Gag Order. Yesterday, many of these contingencies were shocked when he made a public show of killing the birth control provision. The costs and benefits of this particular tradeoff are sure to fuel much discussion in the Media Consortium and beyond.