Booman Tribune

Contraceptives in the Stimulus

by BooMan
Tue Jan 27th, 2009 at 11:37:57 AM EST

Glenn Thrush, of Politico, attempts to explain the debate over family planning funding in the Stimulus Package:

Drudge, along with CNN and others, is trumpeting a House GOP talking point — ridiculing Pelosi’s support of a Medicaid waiver in the stimulus package to reimburse states for contraceptives. Republicans think they have a winner, a classic gays-in-the-military, honeymoon-killing wedge issue.

While Thrush's reporting is technically accurate, the waiver is for family planning programs. Twenty-seven states have successfully applied for a federal waiver that allows them to supply family planning as part of their Medicaid program. Contraceptives are obviously a critical part of any family planning program, but they are far from the only factor in family planning.

Family planning is people planning when to have children,[1] and the use of birth control[2][3] and other techniques to implement such plans. Other techniques commonly used include sexuality education[4][3], prevention and management of sexually transmitted infections[3], preconceptional counseling[3] and management, and infertility management[2].

Family planning is sometimes used as a synonym for the use of birth control, though it often includes more.

It's insulting and inaccurate to use 'contraceptives' and 'family planning' as synonyms. There is no reason for Thrush to concede this construction in his reporting. Family planning involves preparation to have a family just as often as it involves education and tools to avoid or put-off having a family. A major component of family planning is education about reproduction (including contraception and fertility), parenting, and sexually transmitted disease.

The Republicans are making hay about contraceptives, but it is a distorted and dishonest talking point. Reporters should set the record straight on the facts before they analyze the effectiveness of the talking point. They shouldn't reinforce the talking point before analyzing it.

Having said that, even if the Republicans were using the term 'family planning' it is difficult to defend the economically stimulative effects of family planning funding. Most people see family planning funding as a program for helping (mostly) poor women, and not as a way to create jobs or jump start the economy. Even Nancy Pelosi was inclined to argue the waiver was a cost-reducing measure rather than a strictly stimulative one. Good family planning programs will reduce the cost of providing health care (CBO estimates it will save $200 million over five years).

Of course, eliminating the waiver would save some jobs, and perhaps create a few. Over the Bush years, the federal government has dramatically reduced its subsidization of contraceptives under Title X of the Public Health Service Act. This forces family planning organizations to use more of their limited budgets on providing contraceptives and can result in loss of staff.

Removing the waiver requirement would allow all 50 states to get Medicaid reimbursement for family planning programs without going through any bureaucratic hoops. It is, without any question, good policy, and it shouldn't be controversial. However, it is not easy to explain why this policy change belongs in the Stimulus Package. It could be added to some other must-pass bill, or the federal government could just approve all waivers on an expedited basis.

There is more than one way to skin a cat. Having said that, the most effective policy is to eliminate the waiver. It's the right thing to do. If this piece is dropped from the Stimulus Package to avoid offending Republicans, it will send an unfortunate message to women and it will require a later remedy or work-around.



Display:
It's an ongoing wank.
by BooMan on Tue Jan 27th, 2009 at 11:58:33 AM EST
I'd actually be a little cautious about what permanent spending is included in the stimulus package: if there is a renewal requirement for spending after a certain date (some are pushing for a two year limit for stimulus spending, etc.), then all these 'hot spending issues' will come up again, and in what will likely be less bi-partisan times. I'd at least maintain a list of spending items that would be better handled with a later remedy or work around rather than debated again after a potential sunset of the stimulus spending.

Declaring the bottom is the only way back up..
by anarchronarchist (mincers (-at-) hotmail (-dot-) com) on Tue Jan 27th, 2009 at 12:00:43 PM EST
Be careful.  As I understand it, the 'funding' for family planning is not actually direct funding.  Rather, it is the removal of a requirement that state's receive a waiver in order to receive reimbursement for family planning coverage.  So, there is an implied cost, but the authorization (or appropriation) is created under the Medicaid bill.  

If the removal of the waiver were to sunset, then it is possible that we would revert to the present system where 23 states do not get funding for family planning.  But those 23 states could still apply for the waiver, or it could be handled with a patch.

by BooMan on Tue Jan 27th, 2009 at 12:09:07 PM EST
[ Parent ]
It seems an unnecessary distraction.  Pass it later in connection with other health care policy proposals.  

And don't lump "women" into one category.  It wouldn't send an unfortunate message to me and I'm a woman. Strange as it may seem some women are able to separate issues in their minds.  

If there are later health care policy proposals and it gets dropped THEN I will see it as an unfortunate message.  

by maryb2004 on Tue Jan 27th, 2009 at 12:16:20 PM EST
It's a distraction, but it's also good policy and we should have the votes to pass it.  We can afford to be accommodating and also to be strategically shrewd, but I don't think we should necessarily back down on this.
by BooMan on Tue Jan 27th, 2009 at 12:38:03 PM EST
[ Parent ]
You yourself say its hard to defend it as a stimulus.  This is a stimulus package.  If it isn't a stimulus take it out and pass it separately or with another bill where it makes sense to include it.

I might feel differently if I didn't think stimulus was so important. But we can't delay.

Besides, putting stuff like this in a bill is just typical of Congress - loading up bills with provisions that have very little to do with what the purpose of the bill is.  And if I see it that way, how much more would the average person see it that way.

by maryb2004 on Tue Jan 27th, 2009 at 12:45:23 PM EST
[ Parent ]
The average person is paying attention to American Idol or the Super Bowl, not the details of legislation being bandied about in Congress.

The Underground Railroad
by Oscar In Louisville on Tue Jan 27th, 2009 at 12:47:39 PM EST
[ Parent ]
True.  That's why generalizations about Congress work with them.
by maryb2004 on Tue Jan 27th, 2009 at 12:51:34 PM EST
[ Parent ]
well, we did the first part (not that it will win us more than a handful of votes), but we now have to be sure to do the second.  And we just rewarded bad behavior, which normally ensures more bad behavior in the future.  
by BooMan on Tue Jan 27th, 2009 at 01:04:40 PM EST
[ Parent ]
What we should never have done is put in those ineffective tax breaks. THAT was rewarding bad behavior.

On this issue - truthfully I think it harms the Republicans more.  No one can explain why this needed to be in a stimulus bill.  No one.

So we take it out. and the Republicans vote against the bill - just like they were ALWAYS going to vote against the bill. But now they can't use this as an excuse.  There is no excuse. They just didn't want to do anything for the economy.

It makes it so much easier to point out their bad behavior.

by maryb2004 on Tue Jan 27th, 2009 at 01:09:28 PM EST
[ Parent ]
if you look at the stimulus bill, it is absolutely larded with Democratic wish lists which have little to only tangential stimulative potential.  It's a big fuck you omnibus bill.  It's kinda funny that they chose to obsess over Teh Pill, but they'll move to something else this afternoon.  CabinGirl's guess about grass sead is a good bet.
by BooMan on Tue Jan 27th, 2009 at 01:13:29 PM EST
[ Parent ]
Grass seed doesn't have the emotional impact that the words "family planning" and "contraception" do  in this country.  Let them try to blame it on grass seed.  I'm willing to avoid the weeds of a family planning debate to just move on and get the thing passed.  Looks like Obama agrees with me.
by maryb2004 on Tue Jan 27th, 2009 at 01:17:32 PM EST
[ Parent ]
well, I definitely understand your analysis.  I don't think brendan sees it quite the same way.  Heh.
by BooMan on Tue Jan 27th, 2009 at 01:21:20 PM EST
[ Parent ]
I see it as a disgraceful sell-out of low-income families, not just women.

i have a 5 year old, and my child support claims about 30% of my monthly pay. when you add that to the mortgage, the bills, gasoline, student loan payments, i am just barely squeaking by. i make substantially more than $23K, which is median income for low-income families in philadelphia.

i hope they fix this. i do not cotton to rewarding bad behavior.

John Mccain Called his wife WHAT??

by brendan on Tue Jan 27th, 2009 at 01:53:23 PM EST
[ Parent ]
Here's a good piece on how Obey larded the bill with liberal priorities.
by BooMan on Tue Jan 27th, 2009 at 02:09:28 PM EST
[ Parent ]
that's great stuff.

i still think it's hilariously shameful that the democrats bent poor people over the dumpster for the GOP, and the GOP STILL pulled the football away.

I'm actually going to call boehner's office and congratulate him for his skill at playing the charlie brown/lucy stunt (kinda the same way i congratulated that dude that embarrassed Steny Hoyer with the imepachment stunt last year).  

i can't believe that the democrats fell for it again.. oh wait, yes I can.

John Mccain Called his wife WHAT??

by brendan on Tue Jan 27th, 2009 at 02:36:48 PM EST
[ Parent ]
I think GOP may be misunderestimating how sick the US public is of the games they play, and how much pain the economy is exacting on people everywhere.

"Little people are very stuff-intensive."
by CabinGirl on Tue Jan 27th, 2009 at 01:57:42 PM EST
[ Parent ]
You think this is a Peace In Our Time™ moment for the Democrats?

The Underground Railroad
by Oscar In Louisville on Tue Jan 27th, 2009 at 12:45:27 PM EST
[ Parent ]
Not really.  

It's just needless compromising.  The upside is unlikely to be balanced out by the downside.  

by BooMan on Tue Jan 27th, 2009 at 01:05:55 PM EST
[ Parent ]
Too late. We just did.

"If you look for the social economic motive, you will not have to wait for history to tell you what was propaganda and what was truth." - George Seldes
by Real History Lisa (lpeaseRemoveThis@gte.net) on Tue Jan 27th, 2009 at 12:56:35 PM EST
[ Parent ]
And no one will have been able to predict that, after the Dems have committed the cardinal sign of rewarding GOP behavior you don't want, the GOP will vote against the bill anyway because it will plant grass seed on the National Mall.

"Little people are very stuff-intensive."
by CabinGirl on Tue Jan 27th, 2009 at 12:59:50 PM EST
[ Parent ]
yup, here's boner:

House Republican Leader John A. Boehner and his No. 2, Whip Eric Cantor, told their rank-and-file members Tuesday morning during a closed-door meeting to oppose the bill when it comes to the floor Wednesday, according to an aide familiar with the discussion. Boehner told members that he's voting against the stimulus, and Cantor told the assembled Republicans that there wasn't any reason for them to support the measure, according to another person in the room. Cantor and his whip team are going to urge GOP members to oppose it.

Someone should send lollipops to the House democrats and the Obama adminsitration, because they're a bunch of all-day-suckers.

John Mccain Called his wife WHAT??

by brendan on Tue Jan 27th, 2009 at 01:15:31 PM EST
[ Parent ]

Gaaaawwwwwlllyyyy!

Shazzam, whooda figerred that would happen?

"Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity"

by MikeInOhio on Tue Jan 27th, 2009 at 01:22:07 PM EST
[ Parent ]
in fairness, brendan, we don't give even half of a shit about the House GOP.  
by BooMan on Tue Jan 27th, 2009 at 01:22:42 PM EST
[ Parent ]
if by "we" you mean members of BMT, I agree.

if you mean "the house democrats", it would appear they give more of a shit about the GOP's widdle feewings than they do about low-income families.  Not that THAT'S a surprise.  Actions always speak louder than words.

John Mccain Called his wife WHAT??

by brendan on Tue Jan 27th, 2009 at 01:32:06 PM EST
[ Parent ]
No, I mean that this is aimed at gaining Senate support.
by BooMan on Tue Jan 27th, 2009 at 01:33:24 PM EST
[ Parent ]
To drive home my point, the Senate Appropriations Committee just approved the stimulus by a 21-9 vote (via Inouye office email).  But the committee has a 17-13 split.

That means that four Republican members of Appropriations just voted for the bill.  In other words, we have cloture and the bill will pass.

by BooMan on Tue Jan 27th, 2009 at 02:15:17 PM EST
[ Parent ]
I guess I understand the political calculus in trying to "avoid offending Republicans".   But it is becoming ever more apparent by the minute that this effort is foolish.  The Republicans, of course, are simply playing political games with this just like they do everything.  Holding up a stimulus package over condoms!  I mean, c'mon!  Does anyone believe they are serious about that?

The Republicans do not want the stimulus to succeed.  They don't want Obama to succeed.  Or at least they don't want him to get credit for success.  They are going to continue to play these petty and dangerous games.  This whole ephemeral charade they are executing serves only to buy time while attempting to chip away at Obama's political capital as much as they can.  All the while fully intending to vote, wholly, against the stimulus bill whenever it finally comes down to a vote.

So "Nice Try" President Obama.  We have to give you credit.  You did the requisite bipartisan dance with the devils.  And the devils did the only thing they know to do.  They butt-f@#$ed you while all the time keeping a smile on their collective faces.

So now, I hope, you do what probably should have been done from the beginning.  Tell Boehner and McConnell to kiss your ass.  Pass the damn bill and let the Republicans spend their time blowing off on Fox while continuing to dig their own political graves.

"I won!, you say?  Well the time has come for you to claim your prize for winning.

Take charge now.  Please!

"Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity"

by MikeInOhio on Tue Jan 27th, 2009 at 12:55:09 PM EST
"There is more than one way to skin a cat. Having said that, the most effective policy is to eliminate the waiver. It's the right thing to do. If this piece is dropped from the Stimulus Package to avoid offending Republicans, it will send an unfortunate message to women and it will require a later remedy or work-around."

yeah well guess what: it's getting cut. I heard it from Bob Brady's legislative aide personally.

And yes, the fundign would indeed help the economy (warning, PDF):

The results provide strong evidence that income-based family planning waivers reduce births, particularly for younger women. The first column of Table 2 summarizes the estimated impact of these income-based waivers. They have the largest impact on women 18-19 and 20-24 years of age. Our estimates indicate that birth rates for women in these two age groups fell by 6.8 percent and 5.1 percent, respectively. The estimated impact on birth rates for younger teens and women age 25 and over are small and not statistically significant. Looking at women by race/ethnicity, we estimate the largest impacts for Hispanic women, but these differences by racial/ethnic group are not statistically significant. Finally, looking separately by education groups, we find that the policy has its greatest impact on women with a high school degree or less. Since the policy is targeted at lower-income women, and since women with lower levels of education are more likely to be low-income, this finding provides additional support for the claim that our empirical estimates are identifying a causal effect of the policy.

So Changey McHopesalot just fucked poor women to get the GOP on board, and OMG WHO COULD PREDICTED IT, but the GOP AIN'T GONNA SUPPORT THE STIMULUS ANYWAY. Well surprise, surprise, surprise, can you imagine that?  Who could have predicted the republicans weren't acting in good faith?

Smell the change you can believe in. It smells like an unwanted child's dirty diaper.

Hope. Change. Smell it. Wipe it.  Pay for it for the next 18 years.

John Mccain Called his wife WHAT??

by brendan on Tue Jan 27th, 2009 at 01:12:59 PM EST
Yeah.  It's now incumbent to fix this is some other bill.  If he does that, no harm, no foul.  But it did reward bad behavior, and I'm not in favor of doing that.  
by BooMan on Tue Jan 27th, 2009 at 01:20:09 PM EST
[ Parent ]
I'm not crazy about making the stimulus bill a Christmas tree. In fact, I think the IMHO bogus tax cuts should be in a separate bill from the actual spending stimulus which has overwhelming support from economists.
by The Voice In The Wilderness on Tue Jan 27th, 2009 at 06:00:12 PM EST


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