Chelsea Lenhart, MPA, Staff Writer, Brief Policy Perspectives

2015 shifted the political climate and put Planned Parenthood on the defensive. In July, the anti-abortion group Center for Medical Progress released undercover videos showing what they claimed was evidence of Planned Parenthood selling fetal tissue remains. The videos acted as kerosene to a small fire, and within days anti-abortion groups around the country were calling for Planned Parenthood’s head on a stake. By September, the majority Republican House passed H.R. 3134, more popularly known as the Defund Planned Parenthood Act of 2015.

The proposed legislation would freeze the $450 million in federal funding for Planned Parenthood (including any of its affiliates or clinics) for one year. Because the Hyde Amendment already prevents the use of federal funding for abortions, any Planned Parenthood affiliate that certifies it will not perform abortions (or provide any funds to a clinic or entity that does) during the fiscal year will still receive federal funding. The objective behind the proposed legislation is that by eliminating federal funding  to clinics that provide abortions,  the practice of abortion will ultimately stop. Only Texas has passed legislation similar to this proposal, and it is arguably not an effective policy.

The Congressional Budget Office (CBO) produced an “estimated budgetary impact of permanently prohibiting federal funding for Planned Parenthood,” that resulted in a direct spending increase of approximately $130 million between the years 2016 and 2025. Even after the report was released on September 16, the

House still passed the legislation two days later, indicating the projection didn’t resonate with those adamant about stripping Planned Parenthood of its federal funding. The “pro-life” argument, strongly focused on “saving” the life of fetuses, wasn’t deterred by the lack of sound economic principles. However, a cost-benefit analysis reveals that defunding Planned Parenthood is a step backwards economically for the American public.

Cost-Benefit Analysis

In 2013-2014, Planned Parenthood served more than one million individuals, with services ranging  from pap smears and breast cancer exams to providing information about contraception and family planning. According to the organization’s annual report, only 3% of all services provided each year are abortions. This figure, however, is highly contested, with some believing that the percentage of abortions falls anywhere between 7% and 37% percent. Regardless, Planned Parenthood indicates that they performed 327,653 abortions during 2013-2014.

Planned Parenthood primarily serves a  low-income population (roughly 78%). These patients rely heavily on the subsidized services the organization provides, and may not be able to find affordable reproductive health care elsewhere. Indeed, Planned Parenthood is the sole reproductive health service provider in 103 of the 491 counties (21%) in which it operates, indicating that patients living in these communities have an even smaller chance of receiving care  from another provider.

In order to estimate the potential costs and benefits of defunding Planned Parenthood, we must assume that some fraction of the 327,653 abortions provided by Planned Parenthood each year, based upon patient income and locality, would not be performed at other locations were  Planned Parenthood to be defunded. If Planned Parenthood is the only provider in approximately 21% of the counties where it operates, and 78% of Planned Parenthood’s clients are low income, suggesting that they have no other options for services, then we can derive that its absence would result in approximately 53,670 women without a provider (total abortions multiplied by the  percentage of low income clients multiplied by the share of counties with  no other options). It’s reasonable to assume these women would consequently be forced to carry their pregnancy to term, or in some cases to find illegal (and often dangerous) means of terminating the pregnancy. Before the 1973 Roe v. Wade decision, approximately 5,000 women died annually from illegal/unsafe abortions.

Inequitable Policy Distribution

Low-income women will be disproportionately  burdened if Planned Parenthood loses federal funding. The societal costs of defunding, however, will ultimately fall back on the taxpayer. For instance, many of these women (who are forced to carry an unwanted pregnancy to term) will require Medicaid funding for the term of their pregnancy. Both Medicaid and the Children’s Health Insurance Program (CHIP) provide health coverage to half of all low-income mothers and their children. Based on the assumption that there will be an increase of 53,670 full-term pregnancies if Planned Parenthood is defunded, this would suggest that  26,835 of the averted abortions will be partially or wholly covered by Medicaid (i.e. taxpayer) funding.

Long-term consequences of defunding Planned Parenthood will also burn a hole through taxpayers’ pockets. Of the 53,670 additional pregnancies brought to term each year, children of these births are four times more likely than “wanted children” to commit a crime between the ages of 18 and 24, and will be incarcerated as consequence. Two studies, one by the Brookings Institute and another by economists John Donohue and Steven Levitt, connect disadvantaged youth to higher crime rates. In these studies, “unwanted” youth, or those who resulted from lack of access to abortion services, are even more likely to commit a crime. With the current annual cost of incarcerating one individual listed at nearly $31,000, the costs in the future of incarcerating up to 12,720 additional youths will be quite a burden on society.

The “Value” of a Fetus (Valuing the Moral Argument)

Calculating the current costs as described above means that defunding Planned Parenthood would result in a negative net-benefit in the billions of dollars. This financial analysis, however, does little to address  the “morality” argument associated with the pro-life movement. The belief that an unborn fetus is a life changes the assumptions underlying the cost-benefit analysis. The current Value of Statistical Life (VSL) – an economic framework used to gauge how much society is hypothetically willing to pay in order to save a life –  used by some federal agencies is $9.2 million per person. However, because only 44 percent of the population is “pro-life,” the VSL of a fetus should be subsequently adjusted to $4.04 million. With this value, even if only 53,670 previous abortions instead resulted in live births, the policy decision to defund Planned Parenthood would actually result in a net-benefit beyond the hundred billions.

Calculating Other Costs and Benefits

There are numerous other costs and benefits associated with stripping Planned Parenthood of its federal funding. In addition to what is outlined above, there are also repercussions for medical research funding, and the potential for Planned Parenthood employees to lose their jobs. Other benefits include the increase in patients that non-Planned Parenthood service providers might experience.

Ultimately, the argument to defund Planned Parenthood boils down to two main perspectives: one that believes a fetus is a life and should be treated as such and one that doesn’t. It’s clear through America’s history that creating legislation on the basis of perceived morality is much more difficult than legislating through sound data and economic analysis. In the case of defunding Planned Parenthood, we should pursue the path that leads to highest net benefit for all of society, and re-frame the moral argument.    

If you would like to read more about the consequences of defunding Planned Parenthood, please email Chelsea Lenhart at clenhart@gwu.edu to request a copy of her working draft “Cost or Benefit: Analyzing the Potential Effects of H.R. 3134”