Plan B Politics: Title X Clinics Take the Pill Off the Table

Photo by Kate AnneWhen Weld County commissioners decided to stop providing emergency contraception to county patients, concerns rooted in anti-abortion politics trumped scientific facts and testimony provided by the county’s medical chief, according to documents obtained by The Colorado Independent.

Board meeting minutes from the summer of 2010 detail how members led by Commissioner William Garcia were concerned that the popular Plan B contraception drug dispensed at the county’s low-income Title X family-planning clinics prevented pregnancy by destroying fertilized eggs, or inducing abortions, as they put it. Garcia cited reports he found on the Internet to bolster his case and, echoing rhetoric made popular over the last four years by abortion opponents battling health-care reform, he said the board should eliminate Plan B from the county’s services because the law of the land bars tax funding for abortions.

No fertilized eggs

Dr. Mark Wallace, who directs the county’s health department, explained to commissioners on at least three separate occasions that summer that Plan B contraception can not abort a fertilized egg. He recommended Weld County continue to dispense Plan B, and he objected to Garcia’s proposal to include any language in the county’s Title X contract that would suggest Plan B was an abortion drug.

“Dr Wallace stated he has a strong professional opinion that Plan B does not disrupt established pregnancies,” the record of the July 12 meeting reads. “[Wallace] stated the language placed in the agreement regarding Plan B should be medically accurate and should not refer to [PlanB] as an abortive agent.”

Commissioner Barbara Kirkmeyer – the only woman on the five-member board – was concerned that Garcia’s proposals would put funding at risk and bring popular county family planning services to an end.

An anti-abortion Republican, Kirkmeyer, was sympathetic to her colleagues’ concerns, but she felt the research cited to support Garcia’s proposals was unproven.

“Plan B is basically a high-dose birth control pill,” she argued, according to the minutes from a May 24 meeting. “Why is there concern with [Plan B] and not standard forms [of birth control]? A lot of women have and will benefit from this type of counseling,” she said.

Despite Wallace’s testimony and initial pushback from Commissioner Kirkmeyer, Garcia’s motion carried unanimously. After roughly a decade providing emergency contraception, Weld County’s clinics stopped dispensing Plan B pills. Conservative Weld and El Paso are the only two counties in Colorado where official policy is to not offer Plan B. Instead, the counties refer patients asking for emergency contraception to other low-cost providers, mainly to Planned Parenthood.

Both Weld and El Paso pull in hundreds of thousands of dollars each year to run their Title X family-planning services. Weld County has drawn roughly $400,000 annually.

The programs are administered through the Colorado Department of Health, which oversees all of the $3.8 million Title X grant money dispensed in the state. That federal money draws state and local grants that fully total roughly $10 million. Apart from the three clinics located in Weld and El Paso counties, all of the state’s other 25 Title X clinics provide emergency contraception.

State health department spokesperson Jodi Camp said the Weld and El Paso programs are fully compliant with grant requirements, even without providing the Plan B pills. She lauded the Weld clinics as well-run facilities that provide a wide range of services to the county’s patients.

’Something hypocritical’

But abortion rights advocates aren’t so keen about county politicians limiting health-care options for women.

“For the great majority of the population, there’s nothing controversial about birth control,” said Monica McCafferty, spokesperson for Planned Parenthood of the Rocky Mountains. She said she found “something hypocritical” about the Weld County decision, noting that Planned Parenthood has been under attack since the Republican swing election of 2010, when conservative lawmakers around the country began seeking to strip funding from the organization as part of a broad-brush anti-abortion campaign.

“There’s a revealing tension in instances like this,” she said. “The [Weld] county health department sees Planned Parenthood as a critical provider of care. They’re glad we’re part of the community. They recognize that providing access to basic services is the main part of what we do. But we’re also an easy political target, so they attack us even while, in some ways, relying on our donors to provide services."

An El Paso plan B

A spokesperson for the Weld County board told The Independent that the commissioners have no plans for now to review their emergency contraception policy.

But in El Paso County, Public Health Director Jill Law said that perhaps the time has come for her county to review its stance on Plan B.

She said the Title X clinic in El Paso has never, as far as she knows, offered emergency contraception, so the policy isn’t tied to any recent abortion politics. She also noted that El Paso is different from Weld in that health policy in El Paso is made by a nine-member health board that includes two members with medical training.

“These decisions can go along with trends and political views,” she said. “Plan B is not an abortion drug. We know that.”

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