Moments after the House handed a bill to considerably overhaul the nation’s health care system, Rep. Barry Loudermilk, R-Ga., blasted an e-mail to constituents. While the bill “doesn’t fix the entire problem,” he stated, it “begins the process of fixing our broken health care system.”
A PolitiFact reader despatched us a replica of Loudermilk’s e mail and requested us to fact-check it. We zeroed in on one of many exchanges in a “frequently asked questions” part that sought to elucidate a few of the bill’s provisions:
“Why are you cutting women’s health services?”
“We’re not. In fact, we’re expanding women’s access to health services by redirecting Planned Parenthood dollars to community health centers, which vastly outnumber Planned Parenthood clinics.”
Could pushing Planned Parenthood out of the image actually expand women’s entry to health care? After wanting on the proof, we do not see how.
The GOP health care bill bill would successfully block Planned Parenthood for a yr from securing reimbursements from Medicaid — not only for abortions, which is already the case, however for any providers, from pap smears to contraception.
Planned Parenthood says abortion providers are already walled off from funds they get for providers that don’t have anything to do with abortion. But abortion opponents have lengthy argued that the federal government is tacitly supporting abortion even by reimbursing Planned Parenthood for non-abortion providers, saying such cash is fungible as soon as it reaches Planned Parenthood’s coffers.
The bill’s change might have a big influence on Planned Parenthood: About 43 % of the group’s price range comes from the federal government, together with grants and reimbursements, a lot of which comes from Medicaid. The group says the bill, if enacted, might result in closures of clinics and depart women with out entry to very important providers, particularly in medically underserved areas.
Planned Parenthood acquired about $553.7 million from the federal government in 2015 for its providers. The bill does add cash for group health facilities, however solely about $422 million for 2017. So that is not an enlargement of health providers or a easy redirection of funds.
When we contacted Loudermilk’s workplace concerning the Planned Parenthood assertion, they advised us that the knowledge within the FAQ part got here from the workplace of House Speaker Paul Ryan, R-Wis. “Our goal is making sure women get the kind of care they need and we believe that can best be achieved by putting money into community health centers, which provide similar services as Planned Parenthood but vastly outnumber them,” stated AshLee Strong, a spokeswoman for Ryan.
From our analysis, we discovered that there are certainly extra group health facilities than Planned Parenthood clinics — however that doesn’t imply that redirecting dollars to them will quantity to “expanding women’s access to health services.”
Do group health facilities “vastly outnumber” Planned Parenthood clinics?
Loudermilk has some extent on the numbers.
We checked out a census of clinics that present contraceptive providers revealed in April 2017 by the Guttmacher Institute, a reproductive health nonprofit. The group tallied up numerous forms of clinics, probably the most quite a few of that are “federally qualified health centers” — outlined by the federal authorities as “safety-net providers that primarily provide services typically furnished in an outpatient clinic.” Such amenities can embrace group health facilities, migrant health facilities, homeless health care facilities, and public housing main care facilities.
For 2015, the census tallied 5,829 federally certified health facilities nationally, in comparison with 676 Planned Parenthood clinics.
That’s a ratio of larger than Eight-to-1, so the adjective “vastly” appears applicable.
Would redirecting funding to those facilities expand women’s entry to health providers?
This assertion is extra questionable.
For starters, widespread sense means that even when group health facilities ended up with the ability to serve each single affected person presently served by Planned Parenthood, that wouldn’t qualify as “expanding women’s access to health services” — it might merely be sustaining it. The closure of as many as 676 Planned Parenthood amenities would require an terrible lot of enlargement of assets elsewhere simply to maintain tempo, earlier than any “expansion” of entry begins.
And there’s cause to consider that group health facilities might not be capable of decide up the slack if Planned Parenthood facilities disappear.
First, there’s a capability drawback. Planned Parenthood facilities are typically unusually environment friendly in offering health providers to women, as a result of that’s their specialty. The common Planned Parenthood clinic served 2,950 sufferers for contraceptive providers in 2015, in comparison with 320 for the typical federally certified health middle, based on the Guttmacher census.
“Because by definition health centers are in medically underserved communities with elevated risk and insufficient primary care, the last thing one does is get rid of any supply,” Sara Rosenbaum, a professor of health regulation and coverage on the Milken Institute School of Public Health at George Washington University, advised PolitiFact. “This is the corker. Health centers are overwhelmed with need.”
And at present, group health facilities are already working with a scarcity of employees, making any speedy enlargement that a lot trickier.
“Workforce challenges are one of the primary barriers to health center patient growth,” the National Association of Community Health Centers concluded in a 2016 report on its sector. “If all health center clinical vacancies were filled today, health centers could serve 2 million more patients.”
And second, group health facilities and Planned Parenthood clinics aren’t interchangeable, specialists say.
Guttmacher knowledge signifies that Planned Parenthood facilities “are considerably more likely to offer a broad range of contraceptive methods than sites operated by other types of agencies. Nearly all Planned Parenthood health centers offer the full range of Food and Drug Administration-approved reversible contraceptive methods,” in comparison with half of federally certified health facilities.
Rebecca Kreitzer, an assistant professor of public coverage on the University of North Carolina at Chapel Hill, lately informed the Atlantic that oral contraceptives and condoms are low cost sufficient that group health clinics can afford to provide them out after which request federal reimbursement, however IUDs and contraceptive implants — two long-term however reversible strategies — are sometimes too costly for clinics to entrance with out fast cost.
By distinction, Planned Parenthood is a large enough community that it may possibly afford to offer costlier strategies instantly. Because of this, Planned Parenthood clinics are additionally likelier to have employees available with the requisite experience.
“Just because there is a federally qualified health center near where there is a Planned Parenthood Clinic does not mean we can assume the women going to Planned Parenthood would easily be served,” stated Keith J. Mueller, head of the Department of Health Management and Policy on the University of Iowa.
When the Atlantic investigated how ready Iowa health clinics have been to select up sufferers from Planned Parenthood, they discovered that lists of clinics offered by Republican lawmakers included “a dentist’s office, a school nurse, and a youth shelter” in addition to one clinic that had closed and a number of other that didn’t present family-planning providers.
“They’re assuming we’re the alternative,” Ted Boesen, CEO of the non-profit Iowa Primary Care Association, advised the journal. “But we’re waiting to see what kind of a scale it is.”
Loudermilk stated that within the House Republican health care bill, “we’re expanding women’s access to health services by redirecting Planned Parenthood dollars to community health centers, which vastly outnumber Planned Parenthood clinics.”
Purely on the numbers, he has some extent that there are extra federally certified health facilities than Planned Parenthood clinics. But the notion that bypassing Planned Parenthood would imply “expanding” entry is doubtful. Challenges of geography, capability and specialization increase vital questions on whether or not present facilities, even when they have been supplied with Planned Parenthood’s federal income stream, would have the ability to keep the present affected person load, a lot much less expand it. We price the assertion Mostly False.
UPDATE, May 10, 2017: This report has been up to date to incorporate a response from Speaker Paul Ryan’s workplace that we acquired quickly after publication.