Member Spotlight
By: Liz Rich
Wisconsin has long been recognized as a state with a robust publicly funded family planning network that includes a number of high-quality agencies across the state. Nearly two dozen of those agencies are supported by the Title X grant, which has been held by Planned Parenthood of Wisconsin(PPWI) for three and a half decades; the majority are united through the state’s maternal and child health efforts. Despite significant support from communities and recognition that these specialized family planning health centers are essential access points for residents, Governor Scott Walker of Wisconsin has directed his ire at family planning and taken a number of steps to restrict reproductive health and access to affordable health care to women and men across the state since coming into office in 2011.
In 2011, Medicaid eligibility was rolled back in the state from 250% of the federal poverty level (FPL) to 100%, which pushed out 92,000 people from the program, and in the same year, Walker declined to expand Medicaid under the Affordable Care Act (ACA). These individuals had the option to purchase health insurance through the marketplace, and many who were previously enrolled in Medicaid already paid small monthly premiums but still lost their coverage with no guarantee that they would pay the same amount for coverage purchased on the marketplace.
In addition to changes to Medicaid, Walker signed into law a 20-week abortion ban in 2015, which did not include exceptions for rape victims or fetal anomalies. In 2011, he signed a budget into law eliminating state family planning funding to Planned Parenthood of Wisconsin (PPWI) and declined renewing a contract with PPWI to provide cancer screenings. The 2011 state budget also prohibited the provision of abortion care at the University of Wisconsin hospital. Later that year, the state passed legislation prohibiting coverage of abortions in health plans sold in the health insurance marketplace. In 2013, legislation was enacted requiring abortion providers have hospital admitting privileges. As of November 2015, the law has been blocked from going into effect. In 2012, Walker also signed into law legislation repealing Wisconsin’s comprehensive sexuality education policy, which had required sexuality education taught in schools to be age appropriate, medically accurate, and comprehensive. The legislation passed required emphasis of abstinence as the “only reliable way to prevent pregnancy and sexually transmitted infections.” More recently, the governor said that he would sign legislation that would limit only family planning and STD clinics to receiving Medicaid reimbursements for 340B-priced drugs at the actual acquisition cost should the legislature not complete its action to do so. This effort is in spite of the noted congressional intent that the 340B program serve as a revenue source for safety-net programs and that a number of safety net providers bill above acquisition cost to have the ability to reinvest those resources in service delivery. Despite continued attacks on the network, PPWI has worked alongside the expansive network of non-Title X family planning providers across the state in their steadfast, collective commitment to providing high-quality care to those in need.
Since its founding in 1935, Planned Parenthood of Wisconsin has grown into the largest reproductive health care provider in Wisconsin, providing services to 61,000 women and men at 22 health centers across Wisconsin. These health centers provide essential health care services, including contraception, annual wellness exams, breast and cervical cancer screenings, comprehensive sexuality education, colonoscopy services, HPV education, screening, and vaccinations. The affiliate also provides referrals for prenatal care and mammograms and offers abortion care in three of its health centers. More than half of PPWI’s patients report Planned Parenthood health center is their primary health care provider.
PPWI is also the sole Title X grantee for the state of Wisconsin, supporting services at both its own centers and two other subrecipient health care providers that deliver care through 18 health centers. The organization has held the grant for more than 35 years and annually serves 50,000 patients through Title X, 66% of which had incomes at or below 100% of the FPL (an annual income of $11,770 for an individual in 2015). In fact, only 6% of the program’s patients had incomes above 250% of the FPL. In addition to serving patients with Title X funds, PPWI is reimbursed by Medicaid and private insurance, and is also funded with private donations, local government grants, and foundation grants. Wisconsin also has a state plan amendment that expands Medicaid coverage of family planning services for women and men with incomes up to 306% of the FPL. The affiliate previously received state funding for reproductive health care that, as mentioned earlier, ended in 2011.
In addition to providing reproductive and sexual health services, PPWI has undertaken innovative programs to reach patients and provide services and education. For example, PPWI established a text messaging system that allows teens to access confidential sexuality education and get questions answered by a trained professional. The affiliate supports a Promotores de Salud (Community Health Workers) program for many years in the state, which looks to reach low-income and underserved Latino/Hispanic populations and to provide those communities with prevention efforts and increased access to health insurance and to health education. Following the program’s success, it is now expanding to include a comprehensive sexuality education component.
Recognizing the universal hardship agencies have faced resulting from budget cuts and political attacks, PPWI also collaborates closely to advance a unified advocacy agenda. The institution holds a seat on the Wisconsin Family Planning & Reproductive Health Association board. Through these efforts, PPWI stands shoulder to shoulder with other family planning agencies to combat harmful policies and fight for access for the more than 336,000 Wisconsin women in need of affordable family planning services. PPWI, which is proud to be celebrating its 80th anniversary, has withstood challenges and will continue providing high-quality, confidential care, regardless of the political obstacles created by their opponents.