Need a breast exam?
Call your dentist.
What about an HIV test or pap smear?
Find your friendly ophthalmologist.
Looking for a birth-control refill?
No problem. Visit your local nursing home.
These were Louisiana’s utterly unhelpful, sublimely ridiculous recommendations for where to send the 5,200 low-income patients who will lose access to reproductive health services if the state cuts off Medicaid funding for Planned Parenthood, as Gov. (and flagging Republican presidential candidate) Bobby Jindal wants.
Jindal announced the change after some shocking (but possibly misleadingly edited) undercover videos about aborted fetal tissue donations went viral. Of course, under federal law, Medicaid funds already cannot be used for abortion, except under rare and exigent circumstances. More to the point, the two health centers that Planned Parenthood Gulf Coast currently operates in Louisiana – in New Orleans and Baton Rouge – have never provided abortion services in their 30-plus years of existence, according to a spokeswoman. So defunding them would not reduce the number of abortions.
If anything, the much-vilified organization probably depresses abortion demand because it provides patients with birth control. That’s not to mention the other crucial services it provides, given that Louisiana has the highest rates of syphilis and gonorrhea among all states and the second-highest rate of chlamydia. It’s also fifth in HIV prevalence, and the Centers for Disease Control and Prevention estimates it has the highest share of HIV victims who don’t know they’ve been infected.
But, hey, who gives a hoot about public health? Vilifying Planned Parenthood is an easy way to rally the conservative base, which Jindal desperately needs to do, given that among Republican primary voters he’s polling at zero percent (yes, zero) in New Hampshire.
So, Louisiana announced an end to Planned Parenthood’s Medicaid contract with the state, acknowledging in court that the action wasn’t due to concerns about “the competency of these two facilities to provide Medicaid services and adequate care for the patients that they serve.” It just doesn’t want to do business with Planned Parenthood anymore. Other states have enacted similar policies, which have been struck down by federal courts because telling patients they cannot go to the qualified and willing Medicaid provider of their choice violates federal Medicaid law.
Citing such precedents, Planned Parenthood Gulf Coast and three anonymous patients sued to block Jindal’s decision. The plaintiffs also argued the decision would inflict “irreparable harm” to its 5,200 Medicaid patients, who have nowhere else to go.
In response, the state submitted a list of 2,010 other providers these patients could patronize. Except this was not actually a list of family-planning practitioners; it was a list of all Medicaid-enrolled providers – including audiologists, ophthalmologists, radiologists, nursing homes and, yes, dentists.
After a judge questioned the relevance of that list, the state narrowed its offerings to 29 providers. But there’s no evidence these 29 can absorb the thousands of patients who would be displaced, given that Planned Parenthood serves an estimated 30 percent of the female contraceptive clients who use publicly funded clinics in New Orleans and 60 percent of those in Baton Rouge.
Some providers on that pared-down list don’t even prescribe birth control; one has a two-month wait for new patients (which, if you have a time-sensitive need like a Depo-Provera shot or just had a positive cancer screening, is unacceptably long). Some aren’t even taking new patients.
On Friday, the state changed its tack and said it was terminating its relationship with Planned Parenthood for cause. Planned Parenthood expects to continue fighting these efforts.
▪ Republican officials apparently don’t care enough about women’s health to make the effort to really understand it, since some seem to think women get pap smears from their dentists. Perhaps we can chalk that up to the same terrible American sex-ed curricula that produced “legitimate rape” and other mind-bogglingly idiotic comments about how women’s bodies work.
▪ This is a preview of what might happen if congressional Republicans succeed in their attempt to hold the federal budget hostage unless Planned Parenthood is defunded nationwide. There might be a lot of confused patients looking for birth control and, sadly, not finding any at the local nursing home.
▪ It’s probably also an indication of how well thought-through Republicans’ plans to dismantle other major health care programs are. If this is what repealing and replacing Obamacare would look like, be very afraid.
Washington Post Writers Group