Unintended Consequences

House Republicans voted to increase the number of abortions, raise federal health care costs and swell the welfare rolls.

That wasn’t their intent, of course, and certainly not their stated policy. But it is the predictable and inevitable impact of their twin moves to eliminate funding for the federal family planning program and strip Planned Parenthood of all federal money.

If anything, this assessment is understated. The sharper, and still accurate version, would be that Republicans voted to let more women die from breast cancer, cervical cancer and AIDS. How’s that? The family planning programs also provide cancer screening and HIV counseling to millions of low-income and uninsured people.

Let’s be clear about one thing. Almost none of this money went for abortions. The only federal funding for abortion involves the thankfully low number of situations in which poor women seek abortions for pregnancy due to rape or incest, or when their own lives are in jeopardy. In 2006, the last year for which figures are available, the federal government paid for 191 such abortions, according to the Guttmacher Institute.

However, the House cuts are intended to punish abortion providers — specifically, Planned Parenthood, which is simultaneously the largest recipient of federal family planning funds and the largest abortion provider in the country.

Federal law requires Planned Parenthood to carefully separate its abortion expenses from its others. In most instances, abortions are performed in a different building or on a different floor, by different staff. That is not enough to satisfy abortion opponents, who insist that the federal money frees up other funds to underwrite abortions.

But abortions represent 3 percent of the services Planned Parenthood provides; contraception accounts for 35 percent; testing for sexually transmitted diseases, 34 percent; cancer screening and prevention, another 17 percent.

How does the federal money that flows to Planned Parenthood for those purposes differ from, say, Medicare funding that flows to hospitals that also perform abortions? Are those facilities next?

“If Planned Parenthood wants to be involved in providing counseling services and HIV testing, they ought not be in the business of providing abortions,” Indiana Republican Mike Pence, who has led the defunding charge, told Politico. “As long as they aspire to do that, I’ll be after them.”

Last I checked, abortion was legal in this country.

But leave aside Planned Parenthood and turn to the larger question of the Title X family planning program. In introducing his Planned Parenthood defunding, Pence took care to make that distinction. “This legislation does not cut one penny from Title X family planning funding,” he said. “I applaud much of the important work that is done at Title X clinics across this country: breast cancer screening, HIV protection, education, counseling, pregnancy diagnosis.”

Applaud, perhaps, but not fund. A few weeks later, the House spending bill zeroed out all $317 million in Title X funding. An amendment by New York Democrat Nita Lowey to restore the funding did not receive a vote because Lowey did not come up with other cuts to pay for it.

This is crazy — as a matter of both abortion prevention and fiscal prudence.

The Title X program was signed into law in 1970 by Richard Nixon, who proclaimed that “no American woman should be denied access to family planning assistance because of her economic condition.” Title X clinics serve more than 5 million women annually, the vast majority of them low-income.

The Guttmacher Institute has estimated that Title X helps prevent nearly 1 million unintended pregnancies annually. The institute says these pregnancies would otherwise result in 433,000 unintended births and 406,000 abortions.

The inevitable result of eliminating Title X funding would not only be more abortions — it would also be higher bills for taxpayers footing Medicaid and welfare costs for poor children. Guttmacher found that every Title X dollar invested in family planning care saves $3.74 in Medicaid expenditures for pregnant women and their babies during the first year of care. Imagine the lifetime savings.

And then there is the other “important work” that Pence cited: 2.2 million Pap smears, 2.3 million breast exams, nearly 6 million tests for sexually transmitted infections.

If Republicans really believe that this is not a wise use of government funds, they are crazier than I thought.

Ruth Marcus’ e-mail address is marcusr(at symbol)washpost.com.

© 2011, Washington Post Writers Group