One of the most interesting political battles over reproductive health-care access is currently going down in Colorado. As has been extensively documented here at Rewire, an experimental program launched in the state in 2009 has resulted in a shocking 40 percent drop in the teen birth rate and a 35 percent drop in the teen abortion rate. Naturally, Colorado anti-choicers are trying to kill it.
This is about more than some budget struggle. Instead, it’s about the escalating battle over contraception access, both in Colorado and in this country as a whole. Make no mistake about it: The better women get at preventing unintended pregnancy, the uglier this fight is going to get. And intrauterine devices (IUDs), which have an extremely low failure rate, are increasingly at the center.
This week, the National Journal released a massive feature by Nora Caplan-Bricker about the battle over Colorado’s IUD fund. Three years ago, a private donation was made to the Colorado Family Planning Initiative and earmarked to give IUDs and other long-acting reversible contraception (LARCs) to low-income women. The program was a smashing success—not only lowering unintended pregnancy rates, but also saving the state an estimated $5.85 for every dollar spent on the program. Now, the private money for the fund has run out. Democrats, and one Republican named Don Coram, want the state to replenish it.
The arguments for doing so are rock-solid: The program has already saved the state piles of money, unintended pregnancy has all sorts of negative outcomes best avoided, and the demand for the subsidized IUDs is clearly there. But Republicans in the state are most likely going to kill the program anyway.
Roe is gone. The chaos is just beginning.
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What becomes clear, especially reading Caplan-Bricker’s piece, is that Republicans are using this battle to beta-test various arguments against any future attempts, on any level, to make it easier for women to get affordable long-term contraception. It’s a classic case of starting with the conclusion—in this case, that low-income women should not get IUDs—and arguing backwards.
This is a delicate operation for anti-choice Republicans, because they have to find a way to argue against contraception without appearing to do so, which could hurt them with voters in a swing state like Colorado. For months, they’ve been tossing out arguments to see which ones stick. The whole “IUD is abortion!” lie was an early contender, but it has a couple of problems with it, starting with the fact that it’s not true. It’s also hard to imagine the voters of Colorado being unduly impressed by politicians putting the fortunes of hypothetical fertilized eggs ahead of the desires of teen girls to avoid pregnancy.
Now, as Caplan-Bricker reports, Republicans are trying a new tack: Arguing that the program is a redundancy because Obamacare supposedly gives you all the free IUDs your heart desires. She writes:
When the debate finally commences in earnest, moral and religious arguments are scarcer than the initiative’s proponents had expected. Republican House members have settled on a more pragmatic line of attack: The funding, they argue, is unnecessary because the Affordable Care Act requires insurers to cover all forms of contraception—IUDs and implants included. “We don’t need to spend this money on the same program, which is available otherwise,” Rep. Janak Joshi, a Republican from socially conservative Colorado Springs, asserts. “We can use this money for some better use—maybe education, maybe roads, but not duplicating the same services which are available.”
Caplan-Bricker outlines all the reasons why this isn’t true, mostly that there are a lot of holes in the health-care distribution system this program plugs up. It’s obvious, though, that this redundancy argument isn’t being offered sincerely. It’s just a gambit to shut down the program before it becomes entrenched in Colorado—and certainly before it starts to spread to other states, causing unintended pregnancy rates to plummet across the country. The program’s success is the very reason that anti-choicers want to kill it.
While most Republicans stuck to the boring budgetary talking points in Caplan-Bricker’s piece, the real concern leaked out of state representative Kathleen Conti, who called IUDs the “Cadillac” of contraception and argued, very unpersuasively, that “I see firsthand the devastation that happens to” girls who have sex. In other words, her fear appears to be that IUDs work too well—that they’re Cadillacs, as it were—and that without the danger of unintended pregnancy, more girls might choose to have sex.
Common sense would dictate that a high failure rate would be a negative. But from the anti-choice perspective, it’s a good thing. The fact that contraception fails is used all the time as a way to threaten young people in hopes of scaring them away from sex, in anti-choice propaganda and in abstinence-only or abstinence-focused programs. So the IUD, which has a typical-use failure rate of less than 1 percent—compared to 9 percent for the pill and 18 percent for condoms—threatens to upend conservative narratives demanding abstinence across the board for unmarried people.
The same thing happened when the HPV vaccine came out. Prior to the vaccine, abstinence-only propagandists loved HPV, because nearly everyone who has sex gets it at some point, giving credence to the doom-awaits-all-you-fornicators messaging. The vaccine threatened that, and so anti-choicers subjected it to a scare campaign that has, sadly, worked. Many parents still refuse to vaccinate their girls for HPV for fear that it somehow causes risky sexual activity, even though research shows that vaccinated girls actually take fewer sexual risks.
The same thing has been shown, by the way, for birth control: Women who have access to it don’t have more sex. But so what if they did? Sex is a good thing, and we should be able to enjoy it as much as we want without having to incur unnecessary risks. This argument should not be lost in the mix.
As the situation in Colorado shows, conservatives are willing—eager, even—to keep the teen pregnancy rate sky high on the slim hope that doing so might scare someone, sometime out of having sex. At best, that suggests that their priorities are completely screwed up, because they would literally prefer to have widespread preventable public health issues than to admit that it’s fine if people want to have sex. At worst, it suggests that they want people to suffer unnecessary problems like STIs and unintended pregnancy, to punish them for engaging in sexual activity.
Either way, we are at a crossroads here. Most Americans may have mixed feelings about sex, but would be able to set that aside in the face of overwhelming evidence that a teen pregnancy prevention program works. If the Colorado program is allowed to continue, there is no doubt other states will follow.
So this isn’t just a local story. The fate of this little initiative in Colorado could determine the shape of reproductive health care for generations to come.