By Katie Kerwin McCrimmon
A bill aimed at giving young women free or low-cost IUDs and dramatically cutting the teen birth rate in Colorado is expected to be introduced in the Colorado House by the end of this week.
The bill’s sponsors want to spend $5 million in the first year to fund a program at the Colorado Department of Public Health and Environment that would give teens and low-income women access to free or low-cost birth control at clinics across the state.
Since 2009, the Susan Thompson Buffett Foundation — until now identified only as an anonymous donor — has funded the Colorado Family Planning Initiative with a $25 million grant that helped Colorado officials provide more than 30,000 long-acting birth control devices that they say cut the teen birth rate in the state by 40 percent.
In a year when Republicans control the Senate and therefore wield much more power in the Colorado legislature, the bill’s bipartisan sponsors are making the economic argument that spending money up front to give low-income girls and young women access to IUDs and other long-acting birth control implants will save Colorado millions over the long run.
Nearly $6 saved for every dollar spent
State Medicaid programs pay for many teen births — at an average cost of about $11,000 per birth — and health officials estimate that prevention of unwanted pregnancies saved the state between $49 million and $111 million in Medicaid costs from 2010 through 2012. They say every dollar spent to help low-income teens and young women get IUDs or similar long-acting implants will save $5.85.
The bill’s sponsors and health advocates also are trying to appeal to abortion opponents by pointing out that preventing unwanted pregnancies can, in turn, prevent thousands of abortions each year.
“The projections are that as many as 4,300 abortions (per year) won’t happen because the actual pregnancy never occurred,” said Rep. Don Coram, R-Montrose, one of the bill’s co-sponsors. “Everybody talks about ‘don’t stop a beating heart.’ ”
He said he supports preventing unwanted pregnancies “before there’s ever a beating heart.”
Coram also believes the program makes financial sense for Colorado.
“I’m a fiscal conservative. I think this is an opportunity to save the state and federal government a lot of money, “ Coram said.
Teen moms who aren’t ready to have babies often end up dependent on Medicaid and other public assistance programs, he said.
“It’s not a one-month deal. It can be a long time,” Coram said.
In the Senate, the new chair of the health committee, Sen. Kevin Lundberg, R-Berthoud, has said he opposes IUDs because he believes they are abortifacients, a contention that health officials say is incorrect. Coram said he expects to get plenty of support from other Republicans.
“Yes, there absolutely are some from my side of the aisle (who will support this),” Coram said. “I think this is really going to save us a lot of money and it’s going to make a difference in people’s lives.
“I’m not an abortion fan. When babies are born, I want them to be born into a loving family that is ready for that baby and can afford a baby,” Coram said. “It will play very well in my district.”
The other prime sponsor is Rep. KC Becker, D-Boulder, who says she plans to introduce the bill on Friday.
“Unintended pregnancies have a lot of poor social and health outcomes,” Becker said. “When you have a highly effective means (of birth control) that is both effective and has a very strong return on investment, I think it’s smart for us to make sure this program continues.”
On top of preventing unwanted pregnancies, Becker said allowing teens who are sexually active to access birth control they otherwise couldn’t afford will help prevent multi-generational poverty.
She’s optimistic that the bill will gain traction.
“Past history shows that Coloradans support highly-effective means of reducing abortions, reducing unintended pregnancies and helping families determine for themselves the number and spacing of their children,” Becker said. “To me this is just common sense … We do right by our state, right by our families and right by women if we pass this.”
Better to give teens resources than say, ‘Don’t do it’
Sara Vanatta, 20, of Longmont said she chose to get an IUD through the Longmont Teen Clinic in March of 2013 because she knew she didn’t want to have a baby for at least five years and having an IUD would be much simpler than remembering to take a daily birth control pill.
“As stereotypical as it is, teens are often more forgetful,” said Vanatta, who thinks it’s vital to accept that some teens will be sexually active and therefore need access to birth control.
“I think a lot of times people are apprehensive and they don’t want to fund this because they don’t think teens are necessarily old enough to be engaging in sexual activities.
“As much as we want to try to teach abstinence, and we don’t want to fund birth control, that doesn’t stop teens from having sex and doing it unprotected,” Vanatta said. “It’s better to be able to give (teens) knowledge and give them resources in order to protect themselves than to just say, ‘Don’t do it and we’re not going to help you.’
“This is going to reduce the number of unwanted pregnancies, which are super costly,” said Vanatta, who lives on her own, works full time in a restaurant and is a part-time student at Front Range Community College.
“I would like to be a counselor for children. I’m working on that degree right now,” she said.
“(This program) definitely helped me out. I couldn’t have afforded it (an IUD) and there was no way I was taking the pill,” Vanatta said.
As for having a baby at her age, Vanatta said an unwanted pregnancy would have sharply changed the trajectory of her life.
“I do know a lot of people who have just had children. I couldn’t imagine it. I rent a little apartment now. I pay for all my stuff and I can barely do that — rent, car payments and insurance. I can’t imagine supporting a child. There’s probably no way I could go to school.”
Transitioning from grant to state funding to insurance coverage for IUDS
As the bill works its way through the legislature, one of its biggest advocates will be Dr. Larry Wolk, executive director and chief medical officer for the Colorado Department of Public Health and Environment.
Wolk is a pediatrician who specializes in adolescent medicine and still treats teens at the Rocky Mountain Youth Clinics, which he founded.
“This has been a very successful program … and has resulted in a dramatic drop unwanted pregnancies, by 40 percent,” Wolk said. “That’s not just live births. We’ve also had a pretty dramatic drop in abortions is well and a decrease in the number of kids and moms that ended up on Medicaid or applying for WIC (the supplemental nutrition program, Women Infants and Children) or other subsidies.”
“This is a public investment that has a true dollar return. The money that we’re asking for is basically to replicate the (grant) program, but obviously for new women.”
Wolk said the Buffett Foundation has allowed Colorado to launch one of the most successful family planning programs in the country.
“We’ve been able to stretch this $25 million, that was intended to be a 5-year program to more like 6 1/2. They (the funders) are looking for a transition here. There’s really a public benefit.”
Wolk said that the foundation was eager to pilot the program and now wants the state to step up and pay for the devices and training for health workers who implant them.
“Think of it as venture capital. Once you demonstrate you can make this work on your own, you’d like to transition this first to public money. Then we’d like to transition this to insurance money. Given the Affordable Care Act, these devices and implants should be covered,” Wolk said.
The first year of state funding would start at $5 million, then eventually would step down to $2 million per year.
“I hope people will look past any political issues here and really focus on the clinical and health-related issues.
“Certainly, this is not a forced or mandatory program. Women who choose to use birth control should be allowed that choice. This is really providing the support and evidence to what the downstream impacts are,” Wolk said.
“I’ve talked to a number of different folks on both sides of the aisle,” Wolk said. “Many can remember when unintended pregnancy was a more significant problem.”