Women's Rights and Federal Funding for Family Planning Policy

Introduction: The Federal–State Funding Debate

The debate over whether women need special legal protections beyond those enumerated in the U.S. Constitution, as well as the proper funding levels for family planning, has been a source of concern among policymakers at the state and federal levels for decades. State-level proponents of increased federal funding cite the continuing disparities in earnings between male and female workers in the United States, but they also argue that additional family planning support is an absolute necessity to address this broad-based problem — particularly because unplanned children place disproportionate burdens on American women, most especially those already struggling to survive below the national poverty line despite working full-time minimum wage jobs. Conversely, national policymakers maintain that simply directing more money at the problem without accompanying social programs and incentives wastes scarce taxpayer resources, and that states should do more if they feel it is needed.

Against this backdrop, it is important to identify the antecedents of this policy relationship in order to formulate optimal strategies for the future. This paper reviews the relevant peer-reviewed literature together with reliable supplementary resources to describe the major issues facing the U.S. government with respect to women's rights and funding for family planning. It then analyzes the most salient reasons for initiating changes to existing policy, describes the options that must be considered along with their respective pros and cons, and discusses the optimal path forward. A summary of the research and key findings is provided in the conclusion.

From a strictly pragmatic perspective, the major issues facing state governments include the need to receive more federal money than states pay to the federal government. As Scarboro points out, "State-level taxes may be the most visible source of state government revenues for most taxpayers, but it's important to remember that they are not the only source of state revenue. State governments also receive a significant amount of assistance from the federal government" (2). Moreover, some states consistently receive far more federal money than other so-called donor states, making this a highly contentious issue at both the state and federal levels. Studies sponsored by the Kaiser Family Foundation have determined that "the federal government pays 90% of all family planning services and supplies, and states pay 10%. This is considerably higher than the federal match that states receive for most other services, which ranges from 50% to 78%, depending on the state" (Ranji, Salganicoff, and Sobel 4).

Because the type of initiative or capital investment involved in securing federal funding has a major effect on approval outcomes, controversial issues such as women's rights and family planning naturally stand a lesser chance of succeeding in obtaining federal support — especially when states have significantly different laws and regulations on their books compared to federal standards. As Bailey emphasizes, "Family planning policies (i.e., those increasing legal or financial access to modern contraceptives and related education and medical services) have grown increasingly controversial over the last decade" (343).

Historical Origins of Federal Family Planning Policy

The origins of the current controversy over federal support for women's reproductive rights and family planning funding date back to the mid-twentieth century. Early debates over federal and state funding levels reveal that some states attempted to apply what can only be described as social engineering to the problem. According to Welch, "In the 1960s, calls for women's reproductive rights swelled, birth-control advocates demanded that poorer women be granted greater access to contraception. But these demands were tailored to the federal government's growing focus on fighting poverty and a national perception that 'overpopulation' had become a problem, rather than speaking the language of women's rights" (221). In sum, despite the purported goals of federal family planning funding, state-level policymakers — and even federal lawmakers from certain states — consistently attempted to subvert the process to the detriment of intended lower-income female beneficiaries. As Welch notes, during the 1960s:

Expanded access to birth control was essential to limiting the numbers of poor people. Arkansas's example illustrates how, historically, choices about whether and when to have children have been inextricably linked to women's economic situation and how birth control initiatives were often justified as instruments of control rather than individual self-determination. (223)

Given that individual self-determination is at the heart of women's reproductive rights, the rationale behind the bipartisan support for federal family planning funding during the 1960s must be regarded as the result of a cold-blooded cost-benefit analysis that ignored these fundamental rights in an effort to reduce the long-term welfare costs caused by unplanned pregnancies. Welch reports that there was widespread bipartisan support for family planning funding during the Kennedy and Johnson administrations for precisely this reason: "In the 1960s, both Democrats and Republicans supported federally funded family planning, hoping to contain rising welfare costs" (244). Even federal policymakers from some states were advocating federal family planning funding specifically to reduce the welfare burden imposed by lower-income women, most especially minorities. As then-Republican congressman George H. W. Bush observed at the time, "Our national welfare costs are rising phenomenally [and] that [blacks] cannot hope to acquire a larger share of American prosperity without cutting down on births" (as cited in Welch 224).

These policy concerns were regarded as essential to the nation's future, given that the percentage of public welfare recipients had increased significantly after the Aid to Dependent Children initiative was amended in 1961 to include two-parent families — at which point the legislation was renamed Aid to Families with Dependent Children (Welch 225). This single policy change produced a dramatic increase in federal welfare recipients. The number of public assistance recipients nearly doubled from 4.3 million in 1965 to more than 8.5 million by 1970 (Welch 225). In 1970, support from Republican President Richard M. Nixon helped pass the first federal legislation authorizing a national family planning program, driven by the continuing growth of the welfare rolls (Bailey 343).

Legislative Evolution from TANF to the Deficit Reduction Act

In response to these massive increases, bipartisan support for federal family planning funding came under increasing scrutiny during the 1980s. By the mid-1990s, the U.S. government began pursuing additional initiatives targeted at improving the effectiveness of federal family planning programs at the state level, including the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which was subsequently revised by the Aid to Families with Dependent Children provisions and followed by the Temporary Assistance for Needy Families (TANF) initiative (Hawkins and Amato 502).

TANF in particular represented a fundamental shift in policy because it provided states with greater flexibility in administering federal funds. According to Hawkins and Amato, "Under TANF, the federal government provides funds to states in the form of block grants, and states have some discretion in how this money is used" (502). A noteworthy provision of TANF was the ability of states to apply these federal funds to family planning efforts, including support for what was then regarded as the traditional American two-parent family. As Hawkins and Amato note, states could use these dollars to "reduce the frequency of nonmarital pregnancies, and encourage formation and maintenance of marriages and two-parent families" (502).

The success of these federal policy goals encouraged growing numbers of states to identify additional opportunities to use TANF monies to support healthy two-parent families — a trend that received further impetus when the Administration for Children and Families (ACF) began funding pilot research and demonstration programs in the early 2000s (Hawkins and Amato 502). These pilot programs included three large multi-state initiatives targeted at: (a) evaluating the effectiveness of community-level support for healthy marriage initiatives; (b) low-income unwed expectant parents; and (c) low-income married parents (Hawkins and Amato 502).

In 2006, federal support for healthy marriage initiatives expanded further when TANF was reauthorized pursuant to the Deficit Reduction Act of 2005 (Hawkins and Amato 502). This expansion included a specific allocation of $100 million of federal money to support a five-year voluntary educational program for healthy marriage initiatives, as well as $50 million per year targeted at promoting responsible fatherhood initiatives (Hawkins and Amato 502). Although representing only a small percentage of total federal healthcare funding, these modest initiatives were found to be highly effective in promoting healthy marriages among the targeted recipients (Hawkins and Amato 502).

Works Cited

Bailey, Martha J. "Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception." Brookings Papers on Economic Activity, pp. 341–350.

Hawkins, Alan J., and Paul R. Amato. "Are Government-Supported Healthy Marriage Initiatives Affecting Family Demographics? A State-Level Analysis." Family Relations, vol. 62, no. 3, July 2013, pp. 501–511.

Petruney, Tricia, Lucy C. Wilson, and John Stanback. "Family Planning and the Post-2015 Development Agenda." Bulletin of the World Health Organization, vol. 92, no. 8, August 2014, p. 548.

Ranji, Usha, Alina Salganicoff, and Laurie Sobel. "Financing Family Planning Services for Low-income Women: The Role of Public Programs." Kaiser Family Foundation, 11 May 2018, www.kff.org/womens-health-policy/issue-brief/financing-family-planning-services-for-low-income-women-the-role-of-public-programs/.

Scarboro, Morgan. "Which States Rely the Most on Federal Aid?" Tax Foundation, 18 January 2018, taxfoundation.org/state-federal-aid-2018/.

"State Family Planning Funding Restrictions." Guttmacher Institute, 1 March 2018, www.guttmacher.org/state-policy/explore/state-family-planning-funding-restrictions.

Welch, Melanie K. "Not Women's Rights: Birth Control as Poverty Control in Arkansas." The Arkansas Historical Quarterly, vol. 69, no. 3, Autumn 2010, pp. 220–228.