Supporters of abortion rights certainly hit a political brick wall trying to get the Reproductive Parity Act passed in the Republican-steered Washington state Senate this year, despite relatively easy passage in the House. Still, after failing to pass the bill requiring insurance plans to include abortion if they cover maternity, advocates for women’s reproductive rights say they won a lot of what they sought in the state’s two-year operating budget.
That’s right. Republicans who dominate the Senate Majority Caucus were able to head off a vote on a bill requiring insurers to cover abortion, despite a majority of at least 25 Senate members who favor the bill. But the same disciplined majority caucus was unwilling or unable to lop contraceptives programs, family planning and other programs that some of its conservative members objected to.
Advocacy group Planned Parenthood Votes Northwest says one win in the budget was a policy proviso that requires the dispensing of one-year supplies of contraceptive drugs to Medicaid clients unless they ask for smaller amounts. House and Senate bills that would have made that a permanent state policy died.
Planned Parenthood Votes Northwest put out a statement a few days after the Legislature adjourned June 29 saying:
“After facing family planning cuts year after year, our supporters have a lot to be proud of for all the hard work they put in to ensure the safety net for women and families is maintained,” said Treasure Mackley, Political and Organizing Director of Planned Parenthood Votes Northwest. “Our representatives know that standing up this way for women’s health and rights at a time when those rights are under attack across the country makes a statement. Washington is not a place where we will stand for the destruction of women’s basic health care access.”
The advocates’ biggest gain was via the expansion of Medicaid under Obamacare, or the Affordable Care Act. The expansion is expected to extend health care coverage to 250,000 to 300,000 more low income state residents. For women in that pool, their contraceptive drugs and screenings for cervical and breast cancer will be covered.
Despite many Republicans’ concerns about future federal funding of that Medicaid expansion, the expansion is bringing in at least $200 million more money into the state for healthcare, and the expansion helped the Senate GOP’s budget writers balance the books without having to accept additional tax increases favored by House Democrats.
The vote was lopsided for the final budget bill even though it has family planning and other funds that could pay for abortions.
The inclusion of family planning money is among the reasons that conservative Republican Sen. Mike Padden of Spokane Valley voted against the budget. After passage of the budget by a 44-to-4 vote on June 28, Padden’s aides quoted him as saying:
“…while I appreciate that the budget does good things for education without general tax hikes, I can’t go along with the 9 percent-plus increase in overall spending (which is faster than the growth of our economy), nor the funding it provides to Planned Parenthood, nor the fact that it relies on state government’s acceptance of the Affordable Care Act – commonly known as Obamacare.”
Reproductive rights advocates did lose some fights for funding.
Their biggest miss: extra funding for breast and cervical cancer screening and treatment for women who fail to get enrolled by year’s end in health plans through employer-sponsored health plans or policies they buy through the Obamacare insurance exchange once open enrollment begins Oct. 1.
Screening money is cut by $801,000 (26 percent) in the fiscal year that began July 1, and by $2.1 million (76 percent) the following year, according to Planned Parenthood’s analysis.
New enrollment in the Breast and Cervical Cancer Treatment program, which serves about 1,000 women, is eliminated at year’s end. Those already in the program can get treatments on a state-funded basis only. The cutoff is based on the assumption that new patients would buy insurance or go into Medicaid.
But there are people who could fall through the gap if they don’t sign up.
“If they miss open enrollment for the exchange and they find a lump or something like they will be out of luck for a while,’’ said Planned Parenthood Votes’ public policy director Jennifer M. Allen. She intends to ask lawmakers in 2014 to find money to help those who are not covered by insurance.
There also is a lapsing of funds for a Take Charge Family Planning Program. But Allen says that funding is picked up through the expansion of Medicaid for low-income women.
The budget bill, also known as Senate Bill 5034, explains its handling of the breast and cervical cancer treatment program and the Take Charge Family Planning Program this way:
The Breast and Cervical Cancer Treatment (BCCT) program, which covers treatment for approximately 1,000 women diagnosed with breast or cervical cancer with incomes under 300 percent of the FPL, will be eliminated. Clients with incomes over 138 percent of the FPL that are already enrolled in the BCCT program as of January 1, 2014, will retain state-only coverage throughout the course of their treatments. Enrollment in the Take Charge Family Planning program is expected to decrease as a result of the Medicaid expansion. Take Charge provides family planning services for approximately 43,000 clients with incomes under 250 percent of the FPL. Under the Medicaid expansion, clients with incomes under 138 percent of the FPL can receive these services by enrolling in Medicaid, and those with incomes between 138 and 250 percent of the FPL can receive these services through subsidized coverage in the Exchange.
Allen said her hope is that those who need family planning assistance can move into Medicaid. “Therefore we think legislators took appropriate action by making sure that the program, as well as the DOH [Department of Health] reproductive health program, stayed in place to ensure no gaps in birth control access as we move into health reform, but we’re fine with them having reduced the amount budgeted for it based on a likely reduced need.”
The budget also outlines a new policy on contraceptives in a proviso that says contraceptives can be made available on a full-year basis rather than three months. This leads to a $4 million reduction in allocation, but the longer supply of contraceptives is expected to produce state savings so no cuts in service are expected, according to Allen.
Looking ahead, the biggest fight in 2014 will be over the Reproductive Parity Act,Despite fierce resistance in the Senate against bringing or the abortion-insurance bill, which would be the first of its kind nationally at a time an estimated 20 states are taking steps to disallow abortion coverage through the exchanges.
Planned Parenthood and allies will be looking for a way to get Senate Majority Leader Rodney Tom, a pro-choice Democrat, or others in the Senate’s 23-Republican majority caucus, to break ranks and allow a vote on the proposal.
A 25-member majority has signed a letter circulated by Sen. Steve Hobbs in favor of the bill, but Tom has said that bringing the bill to the floor directly from committee would have required a procedural move inviting total chaos on the Senate floor. Sen. Steve Litzow, R-Mercer Island, supported the bill and attended a February rally with Tom and the solidly pro-choice governor.
“What I can tell you is we are going to spend the summer looking for a way to break this deadlock. Reproductive parity is important to Washington women’s reproductive freedom and privacy,” Allen said this week. “We are absolutely committed to finding a way to move this forward. The fact that 25 senators have expressed their support for it we’d sure like to find a way.’’