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Needed: $5 Million to Fund Successful Birth Control Program

A program that cut abortions by 42 percent among teens is scrabbling for cash after a big grant ran out and the state legislature refused to fund it.
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A program that helped cut abortions by 42 percent among teens and cut teen births by 40 percent is scrambling for cash after a big grant ran out and the state legislature refused to fund it.

The Colorado Family Planning Initiative provided free or subsidized birth control to needy, high-risk women.

The program posted a plea for funding last week, and hopes to keep going by cobbling together money from the state, the federal government, and private contributors, said Dr. Larry Wolk, Colorado’s chief medical officer.

“We are trying to find ways to make it continue or happen, but when you lose $5 million a year to make it happen, you have the potential for losing quite a bit of momentum,” Wolk told NBC News.

“We are trying to be as creative as we can be.”

He says the state would be happy to get even half of what it had before. “If we wanted to expand this even further than it has already been expanded we would have to try and make up $5 million,” Wolk said. “At this point we are trying to make up $2.5 million.”

"When you lose $5 million a year to make it happen, you have the potential for losing quite a bit of momentum."

Wolk says the Susan Thompson Buffett Foundation, named for the late wife of billionaire investor Warren Buffett, approached the state in 2009 with the idea: to see if providing the most effective forms of birth control for free to needy teens and young women could help cut the rate of unintended pregnancies, abortions and births.

The U.S. teenage birth rate is seven times higher than rates in other rich countries. State and federal governments and private groups are trying to battle this and looking at the best ways to reduce the rate, with policies ranging from abstinence-only education, to comprehensive sex education, to providing free birth control.

Medical experts from the American Academy of Pediatrics to the American College of Obstetricians and Gynecologists recommend intrauterine devices (IUDs) and implantable birth control drugs as the most effective methods, as well as safe. But research shows only 7 percent of teenagers use these methods, called long-acting reversible contraception.

Instead, they prefer unreliable methods such as condoms and birth control pills.

The program provided free birth control to needy, high-risk young women. It educated doctors, nurses and other caregivers about how to use and administer these methods. “It’s much easier for them to hand out condoms and write prescriptions for birth control pills,” Wolk said.

“It takes time to insert an IUD or a long-acting contraceptive like Norplant.”

The program was a success by any measure. It provided more than 30,000 IUDs or implants at low or no cost to low-income women at 68 family planning clinics.

“Teen birth rates in our state have declined more rapidly than in any other state or the nation as a whole,” the state said in a statement. “The decline in births among young women served by these agencies accounted for three-quarters of the overall decline in the Colorado teen birth rate.”

This saved money.

“The birth rate for Medicaid-eligible women ages 15 to 24 dropped sharply from 2010 to 2012, resulting in an estimated $49 million to $111 million avoided expenses in Medicaid birth-related costs alone.”

The foundation extended the funding for a couple of years, Wolk said, but the point of the grants was to start up pilot projects that could serve as demonstrations to encourage state and federal funding.

So the state asked the legislature to pay for it, but the Republican-led body voted against it. Some lawmakers argued that IUDs are tantamount to abortion, Wolk said. ACOG and other groups say this is untrue but it remains a widely held belief.

Republican state senator Sen. Kevin Lundberg says IUDs can cause abortions.

“Protecting life is a very big issue,” Lundberg said in discussing the funding issue last January. “In my mind, that’s what government is all about, and to protect the life of the most vulnerable and most innocent seems to be the most important.”

“Teen birth rates in our state have declined more rapidly than in any other state or the nation as a whole."

The second barrier: the Affordable Care Act’s requirement that insurers provide birth control for free.

Some lawmakers felt if taxpayers were paying for birth control once, through Medicaid, that they shouldn’t have to pay again to fund this program. “They took a clinical and social program and made it political,” Wolk said.

“We tried to explain that … there are still a lot of gaps,” Wolk said. “Those include provider training.” Studies show many doctors still don’t understand how well IUDs work, for instance.

“And there are still a fair number of women who lack insurance or don’t want their insurance involved,” Wolk added. For instance, teens on their parents’ health insurance plans may not want their parents notified. “The critics will imagine the 12-year-old girl,” said Wolk, a practicing pediatrician. “But they forget you can be a dependent on your parents’ coverage up to age 26.”

People who lack any insurance, even Medicaid, are among those most likely to have an unwanted pregnancy, statistics show.

Plus, the implants and devices are pricey, costing $800 to $900 a pop. Many insurers willnot pay for them and the law only requires that they pay for some form of birth control, not every form.