A state lawmaker in Arkansas this week introduced a proposal that would make long-acting birth control accessible to women on Medicaid -- but only if they are single mothers with one child. Republican state Rep. Kim Hammer explained that the measure would give single mothers on Medicaid “a little bit of a breather to think about their life decisions that are affecting us as taxpayers.”
This isn’t the first time lawmakers have condescended to low-income women while advancing policies to control their fertility. Last year, the vice chair of the Arizona Republican party resigned after he boasted, “You put me in charge of Medicaid, the first thing I’d do is get Norplant, birth-control implants, or tubal ligations. Then, we’ll test recipients for drugs and alcohol, and if you want to [reproduce] or use drugs or alcohol, then get a job.”
Hammer’s proposal is part of a long legacy of policies to coercively and forcefully restrict the fertility of low-income women and women of color. It is also incredibly revealing of the misogyny endemic to conservative family planning policies.
Access to basic reproductive healthcare and the ability to have a family are basic human rights. It is good for individuals and it is good for overall public health. The argument in favor of letting people control their fertility and plan for the families they want is incredibly straightforward.
But as organizations like the Guttmacher Institute have long pointed out, in addition to the myriad personal and health-related benefits (for parents and children), universal access to reproductive healthcare saves taxpayers millions of dollars. (It’s important to note here that people who receive Medicaid are among those taxpayers saving money.)
According to a 2014 analysis from Guttmacher, taxpayers saved $7 for every public dollar invested in family planning.
“Public expenditures for the US family planning program not only prevented unintended pregnancies but also reduced the incidence and impact of preterm and [low birth weight] births, STIs, infertility, and cervical cancer,” according to the report. “This investment saved the government billions of public dollars, equivalent to an estimated taxpayer savings of $7.09 for every public dollar spent.”
The fiscal savings are just a natural consequence of expanding access to birth control and allowing people to plan for the families they want, they aren't engineered by lawmakers like Hammer.
And yet so-called fiscal conservatives are either cutting off access entirely or framing any (limited) expansion of access as tough on so-called government moochers when, in fact, their scorched earth approach to reproductive health is the real problem. These policies, in their incoherence and cynicism, expose the misogyny and reflexive disregard for people living in poverty endemic to the conservative approach to family planning.
What other explanation is there for Republicans across the country costing their states millions by turning their noses at Medicaid and universal access to contraception while their bridges crumble and public schools are put on life support? Or a conservative insistence that people who received government benefits have larger families or spend more recklessly than people who don't use these programs despite this not being the case?
This is how frightening the prospect of women controlling their own fertility really is -- and how rooted in misogyny and attacks on the poor these policies really are. Anything seen as supporting women’s basic human rights must be framed in punitive terms about restricting their ability to have families or, alternatively, fought at every turn.
Guttmacher collects data on reproductive healthcare as part of a broader analysis of its impact on women’s lives. And it’s useful to know that in addition to empowering women to control what happens in their bodies and inside their families, expanded access to contraception is good fiscal policy, too. But it’s also clear that such data has done little to persuade lawmakers to reverse course on draconian policies that shame women and harm real families.
People are needlessly suffering under these policies. But as we recently saw in the Republican budget proposal, the numbers alone will not persuade lawmakers that women and low-income people have a right to control their own bodies and shape their own families.