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Colorado program that reduces teen pregnancy in jeopardy

For six years, the Colorado Family Planning Initiative has been providing free long-term birth control to teens and low-income women. The program has reduced unplanned teen pregnancies by 39 percent, and the abortion rate by 42 percent. The group has been lobbying for state funding, but Republican lawmakers have said no. Special correspondent Mary McCarthy reports.

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  • JUDY WOODRUFF:

    Next: A Colorado birth control program is losing its funding, despite a remarkable track record.

    Special correspondent Mary MacCarthy has our report from Denver.

  • MARY MACCARTHY:

    Victoria Garcia was just 22, with big career plans, when she found out she was pregnant. The news, she said, was jolting.

  • VICTORIA GARCIA, Colorado:

    Motherhood wasn't a stage in my life that I was ready for. I was in college. I was focused on school and getting my degree.

  • MARY MACCARTHY:

    Garcia said she had wanted to use a long-acting birth control method, but couldn't afford it.

  • VICTORIA GARCIA:

    When you're young and you're in college and you're barely making ends meet with food and rent and other menial costs, $500 or $550 for an IUD or an implant out of pocket is — it's outrageous. It's too much.

  • MARY MACCARTHY:

    Garcia had the baby, a son, Liam, and still managed to graduate from college. She credits her mother and husband for helping her. But there's something else she says that had been critical for her success.

  • VICTORIA GARCIA:

    The day I got my IUD placed, the midwife handed this card to me and she said, you don't have to come back until January 2022. This IUD has been life-changing for me. It really has.

    (CROSSTALK)

  • MARY MACCARTHY:

    Freedom.

  • VICTORIA GARCIA:

    Oh my gosh, absolutely.

  • MARY MACCARTHY:

    Garcia received her IUD through a program called the Colorado Family Planning Initiative. It is a privately funded effort to give teens and poor women free access to long-acting reversible contraception.

    The program has had remarkable success since it began six years go. While nationwide, unintended teen pregnancies have dropped by 20 percent, in Colorado, they have dropped by 39 percent, and the abortion rate for teens has dropped by 42 percent.

    But the foundation money for the initiative was due to end in June, so advocates went to the state legislature asking for $5 million a year to continue it. Republicans who control the Senate said no.

    KEVIN LUNDBERG (R), Colorado State Senator: It puzzles me that they insist they need the private — the public funds, when it's actually available through the insurance system.

  • MARY MACCARTHY:

    Republican state Senator Kevin Lundberg says, under the Affordable Care Act, insurance companies must offer free birth control, so state money isn't needed. He also says state funding can't be used for any device that may cause an abortion.

  • KEVIN LUNDBERG:

    The use of the IUD for long-term contraceptives is, in fact, in the estimate of many people, abortifacient. And Colorado law doesn't allow state funding for any direct or indirect purposes of that sort.

  • SUSAN KEITHLEY, Tri-County Health Clinics:

    There are two different IUDs and actually a third is coming out on the market.

  • MARY MACCARTHY:

    But nurse practitioner Susan Keithley, with the Tri-County Health Clinics, explained that an IUD doesn't cause an abortion. It prevents fertilization, and it does so with remarkable effectiveness.

  • SUSAN KEITHLEY:

    The research that's out there on the long-acting reversible contraception is that they're 99 percent effective. So the pregnancy rates with our long acting contraceptives are less than 1 percent.

  • MARY MACCARTHY:

    And these are not your mother's IUDs. Today's versions are far different than the ones that caused disease and even infertility in the 1970s. Last fall, the American Academy of Pediatrics cited their efficacy, safety and ease of use and said they should be considered a first-line option for adolescents.

    But they are expensive, and even after passage of the ACA, many insurance companies are still charging for some methods of birth control. And some women, it's estimated about 5 percent, still don't have insurance because they can't afford it, yet they don't qualify for Medicaid.

    That's the case for college student Shelby Ingel, who came to Tri-County Health two years ago.

    If you came in and they said this device that you're using, it comes at a cost of $400, would you have been able to pay that out of pocket?

  • SHELBY INGEL, Colorado:

    Oh, there's no way. At that point, I was, I think, working at a Papa Murphy's making minimum wage. That would have been a whole month's paycheck or something like that.

  • MARY MACCARTHY:

    Nurse Keithley is disappointed with the legislature's decision and says her clinic can't afford to offer IUDs without the extra funding.

  • SUSAN KEITHLEY:

    I think it can be a tough year ahead, especially with our clients that have benefited from the program and are due to have their devices replaced or renewed, that, again, when they come in, we're going to have to say, oh, I'm so happy you're so pleased and it's worked so well for you, but I'm sorry. We only have these limited options for you right now.

  • MARY MACCARTHY:

    Are you surprised by the numbers, just how successful clinically this program has been?

    DR. LARRY WOLK, Executive Director, Colorado Department of Public Health & Environment: I have to say I was a little surprised.

  • MARY MACCARTHY:

    Dr. Larry Wolk heads the Colorado Department of Public Health. He says it's short-sighted for lawmakers to focus on the costs, when they should be looking at the benefits.

  • DR. LARRY WOLK:

    We have data that says young women who have unintended pregnancies have a higher risk of suffering medical complications. They have a higher risk for living in poverty. The children born to these women have higher risk for medical conditions, not to mention the cost to the public insurance program, whether it's Medicaid, the public assistance programs like food stamps or nutritional programs like WIC.

    We have demonstrated that there's been a decrease in the amount of public services as a result of making these IUDs and implants available.

  • KEVIN LUNDBERG:

    If the promoters of this particular program are that convinced that this has continue, then I would urge them, as 100,000, well, maybe 1,000 other nonprofits around the states are looking for funding for their program, they should go and do the same thing.

  • MARY MACCARTHY:

    That frustrates Victoria Garcia, who says helping poor young women with long-acting birth control should be an obligation of the state.

  • VICTORIA GARCIA:

    It transforms women's lives. Having a long-term birth control method buys you time, time to finish your goals, time to finish school, if that's what you're doing.

  • MARY MACCARTHY:

    Advocates say they're trying to find private funding to continue the program into the new year, but then they will once again lobby the legislature for a long-term financial solution.

    For the PBS NewsHour, I'm Mary MacCarthy in Denver.

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