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Clinics express concerns about meeting increased demand for LARC

November 1, 2016 — Some clinics that provide long-acting reversible contraception (LARC) are struggling financially to meet a heightened demand for such contraception following the presidential election, NPR's "Shots" reports.

Increased demand for LARC

According to "Shots," women following the recent presidential election have shown increased interest in accessing LARC (Ross, "Shots," NPR, 11/23).

President-elect Donald Trump during his campaign pledged to defund Planned Parenthood, which provides contraception among other health care services. In addition, Trump said he would repeal the Affordable Care Act (ACA) (PL 111-148), under which almost all insurance plans are required to cover all birth control approved by the Food and Drug Administration, including intrauterine devices (IUDs) (Women's Health Policy Report, 11/14).

Title X facilities struggle to meet demand

Many Title X facilities already struggle to meet demand, given limited funding. According to "Shots," the Title X program distributes funding for reproductive health services to regional grantees. In turn, the grantees distribute the funds to 3,951 health care facilities across the country, such as local health departments, hospital outpatient facilities and independently operated clinics. Overall, Planned Parenthood operates about 13 percent of those facilities.

According to "Shots," some reproductive health advocates are concerned that the Title X program could be defunded or restricted under the new administration. For instance, lawmakers in Congress over the last few years have proposed multiple bills aimed at blocking the allocation of Title X funds to providers that offer abortion care and a failed measure that would have defunded the Title X program. In addition, Title X funding has decreased over the last few years, declining from $317.5 million in 2010 to $286.5 million in 2016.

Reproductive health organizations report varying donations following election

Following the election earlier this month, Planned Parenthood Federation of America reported an increase in volunteer applications and financial donations, with more than 200,000 individual donations made during one week. However, according to "Shots," many other reproductive health organizations have not experienced a similar increase in financial and volunteer support.

For instance, Susie Markus -- executive director of the Wyoming Health Council, an umbrella group for 15 publicly funded family planning centers in Wyoming -- said her organization has not received any donations since the election. In contrast, she said she has heard individuals in the state express an interest in donating to Planned Parenthood, which operates one clinic in the state.

Local clinics express concern

Some local clinics have reported that their funding via Title X is already so limited that they are having difficulty meeting the increased demand for LARC, while others said they can currently meet demand, but worry about being able to do so if the increased demand for LARC remains high.

Kristen Adams -- president and CEO of the Indiana Family Health Council, which distributes Title X funding to 26 clinics in the state -- said, "At the end of the day, we've decided that if a woman wants an IUD, we will get it for her." However, citing the comparatively high cost of an IUD and IUD insertion, she said, "That means a lot of budget shifting."

Separately, Kate Brogan, vice president for public affairs at Maine Family Planning, said, "Our demand for IUDs has about doubled, but we don't know if that's a short term spike or not. I think it would take a more consistent increase for it to begin to be an issue." According to Brogan, Maine Family Planning has received a small increase in donations.

Brogan added that if Congress were to cut the Title X program, "[t]here's no way we'd be able to maintain [Maine Family Planning's 50-clinic network]."

Amy Moy -- vice president of public affairs at Essential Access Health, a California-based, Title-X funded network of 340 clinics -- said the network provides care for one million patients, or about 25 percent of the people eligible for Title X services in the United States. Moy said the state provides additional family planning funds for low-income populations.

According to Carlina Hansen -- executive director of Women's Community Clinic, an Essential Access Health clinic located in San Francisco -- the clinic received some donations following the election, but not on the same scale as Planned Parenthood. She said if the increase in LARC demand continues, the clinic likely will need to hire more staff and make more appointments. "We already operate at a loss, and donations help us carry that loss," she said, adding, "If we need to increase our staff, balancing our budget gets difficult" ("Shots," NPR, 11/23).