Paul Dillon: Legislature’s investment in family planning providers, increase in Medicaid reimbursement rate crucial

Family planning providers in Spokane and across the state are currently caught between providing care to all who need it and managing an outdated and complicated health insurance system that gives unequal treatment to sexual and reproductive health care.

This system is putting essential health care services at risk. Family planning providers both large and small are experiencing financial hardships – because for the past decade, providers have not received a Medicaid reimbursement rate increase. These rates are the payments that family planning providers receive for serving patients who use Medicaid, and they simply haven’t kept pace with health care costs.

Medicaid reimbursement rates are something most people don’t think about but we are acutely aware of how critical they are in who receives care.

Due to centuries of racist systems and underinvestment, many of these patients – particularly people who identify as Black, Indigenous, or of color (BIPOC), and those in rural communities or medically underserved areas – are covered by Medicaid and would have nowhere else to go for care if they couldn’t access Planned Parenthood health centers.

Every time a Medicaid patient walks through our doors, safety net family planning providers lose nearly $200. Planned Parenthood and other family planning clinics simply cannot sustain these losses, especially with demand growing as the COVID-19 crisis throws families into economic uncertainty and more patients onto Medicaid.

Three health centers in Western Washington closed last month because of this, and more could close across the state–including in Central and Eastern Washington–without funding.

Washington has always been a leader in protecting and expanding reproductive health care. In 1970 we were the first state in the nation for voters to approve the right to access legal abortion. In 1991, we codified Roe v. Wade at the ballot, and in the last four years have fought to make reproductive rights in our state “Trump-proof” by passing policies like the Reproductive Parity Act that expanded the right to safe and legal abortion.

That is what makes this so hard. COVID-19 has laid bare why health care should never come down to how much you earn, where you live, or who you are. A right isn’t a right unless you can access it – and family planning access is becoming a right in name only for those who can afford it.

An investment in Medicaid for family planning is fundamentally an equity issue. Reproductive health equity gives people the opportunity to plan their futures on their own terms.

For over 50 years, Medicaid has provided affordable health insurance coverage to people with limited incomes and resources. The lack of state investment in this joint federal-state program exacerbates the disparities experienced by Medicaid patients, who are disproportionately BIPOC due to systemic racism in health care. This is especially true in Eastern and Central Washington, which is home to rural areas where there are a lack of providers and traveling long distances creates nearly insurmountable barriers to care.

With this investment, we can continue and build on our legacy of standing with Planned Parenthood patients. We can keep our health centers open. We can make sure that everyone in Washington – regardless of income, gender, race, ethnicity, immigration status, ZIP code, ability and more – has equitable access to family planning and reproductive health care. We can do it because we are essential.

There’s hope. Fortunately, Gov. Jay Inslee took the first step with an investment in his budget and now we are seeing the leadership we need in the House and Senate to get this across the finish line by including a funding increase in the Legislature. They will now work together to reconcile a final budget that prioritizes family planning before the Legislature adjourns on April 25th. We are thankful for their support because these are principles our elected leaders believe in and have for decades.

Paul Dillon is the vice president of public affairs for Planned Parenthood of Greater Washington and North Idaho and a board member for Greater Spokane Progress.