As a teenager growing up in small-town Indiana, Elizabeth Miles didn't know that the local Planned Parenthood offered affordable contraception and other subsidized reproductive health services.
"I just wasn't educated," Miles said in an interview. "I knew about it, but wasn't real knowledgeable on what all they did or anything, and I was scared of telling my parents I needed to go there."
Following the birth of her child at age 17, she finally visited the local clinic. At the time, she was unemployed and uninsured, and they were able to provide her a birth control prescription for $3 a month. Now 32, she still visits the same Planned Parenthood in her hometown of Seymour for pap smears, annual check-ups and birth control, because they provided her an affordable way to take control of her reproductive health.
When lawmakers in Washington debate whether to strip federal funds from Planned Parenthood clinics, most of the discussion revolves around the access to abortion that the clinics offer.
But many of their patients never undergo an abortion -- Planned Parenthood estimates that such procedures account for only 4 percent of the services they provide. Most of the rest, the group says, are affordable primary care services, often in rural, low-income parts of the country.
In Miles' hometown -- population 17,503, as of the 2010 U.S. Census -- the Planned Parenthood clinic is the only affordable health care option for people without insurance. She says she's not sure how she would be able to get to the next nearest clinic in Columbus, Ind., if hers were to shut down.
"A lot of people in my town don't have their own transportation," said Miles, a mental health technician. Seymour is about a 30-minute drive from Columbus. "They rely on the 'Recycle to Ride' bus to get around, and the bus won't take you to Columbus. It would be especially hard for the teenagers who want to prevent pregnancy, but don't want to tell their parents."
The teen pregnancy rate in Seymour's home county of Jackson was 4 percent in 2005, according to county-provided data -- nearly double the statewide figure. While there are plenty of regular doctors in Seymour, Miles said, many of them don't take uninsured patients, and the ones that do are too expensive.
"There aren't any options for women that don't have insurance, unless they want to pay $200 to $300 for their pap," she said. "I didn't have insurance for the first four or five years that I went to Planned Parenthood. If it wouldn't have been for them, I would not have been able to have a yearly checkup or be able to be on a birth control. I wouldn't have been able to afford it."
There are 28 Planned Parenthood clinics in Indiana, but the Seymour clinic and the seven others that receive federal funds -- which the organization considers necessary to their continued operation -- may soon be on the chopping block. House Republicans are hoping to eliminate Title X, the federal law which provides funding for family planning services, because while federal law bars those funds from use for abortion services, the GOP argues that the money indirectly supports such activities by helping keep the clinics afloat.
According to Planned Parenthood figures, the Title X funding allows its recipients -- including the group's own clinics and others -- to serve more than 5 million low-income Americans annually. Rep. Mike Pence (R-Ind.), the chief sponsor of the Title X Abortion Provider Prohibition Act, said in a recent radio interview that he appreciates much of the work that such clinics do and has "never advocated reducing funding for Title X" in total, but appeared confused as to where that work is concentrated.
"Title X clinics do important work in our inner cities," Pence said. "They provide health services for women and children that might not otherwise have access to them."
Indeed, a 2009 report by the Guttmacher Institute, a reproductive health research and advocacy group, found that a majority of low-income women consider a family planning center like Planned Parenthood their primary health care provider. But 73 percent of Planned Parenthood clinics are located in rural or medically under-served areas, according to the organization's own data.
The eight clinics in Pence's home state that Planned Parenthood says would be in jeopardy if Title X were eliminated are in the poorest areas of northwest Indiana and the southwest part of the state, which is largely rural. The organization estimates that it receives about a third of its funding from federal programs like Title X.
"I really wish Mr. Pence would do a little bit of homework before he takes to the floor and does what could be real harm to good public health policy," said Betty Cockrum, president and CEO of Planned Parenthood of Indiana. "For funding to be taken away from those rural areas would put a real hardship on the women and men who use those services. Contrary to the arguments we hear, there aren't other health care providers just waiting to step up and provide those services at the cost that Planned Parenthood provides them."
Pence's office did not respond to a request for comment.
But Miles, for one, says her life would have been a lot more difficult if she hadn't been able to start visiting her local Planned Parenthood clinic 15 years ago.
"I obviously needed to be on birth control," she said. "I had no job, no insurance, a baby, and I was living with my parents. There were no other options."
Do you rely on a Title X-funded clinic for health care? Email your stories and comments to LBassett@huffingtonpost.com.
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