In his late-March budget address, New Jersey's Governor Chris Christie announced that the day of reckoning for a debt-awash Garden State had arrived. His spending plan would chart a new course, he promised.
But that course plunges New Jersey into dangerous waters, with women and children going first. Christie proposes slashing all state funding for women's health and reproductive services -- $7.5 million -- in a move that would undermine basic health care and erode fundamental freedoms guaranteed by the law.
No budget crisis can justify the evisceration of women's rights.
That funding allows over 50 health centers across our state to screen thousands of women for potentially fatal diseases such as breast cancer and cervical cancer. The centers dispense birth control, conduct annual gynecological exams, and provide prenatal care so that all children in New Jersey enter the world with a clean bill of health, regardless of their parents' income.
And while some family planning centers here do provide abortions, the procedure constitutes only a sliver of the overall services these centers provide, and moreover, none of the state funding may go toward abortion.
In reality, these centers do more to prevent abortions than to provide them, both in New Jersey and in the country. Rather than decreasing the number of abortions, closing these centers would increase the number of unwanted pregnancies, which health centers could have prevented - the primary goal. In 2009, New Jersey's family planning agencies helped prevent 39,872 unintended pregnancies.
Most of the 140,000 New Jerseyans treated at family planning centers last year were low-income. At least 70 percent of patients relied on family planning clinics as their sole health care provider, lacking health insurance or independent means to pay for medical care. (And New Jersey is hardly alone.)
If these women qualify for benefits under the health care reform bill, they won't kick in until 2014 -- a long time to wait for a checkup. According to The Washington Post, a single mother of two making $25,000 would not be eligible for Medicaid, which extends only to people making 133 percent of the poverty line or below.
The costs quickly add up. Without insurance, birth control costs women hundreds of dollars per year. A routine pap smear to check for potentially deadly diseases can cost patients without insurance hundreds of dollars, but that's the best-case scenario. Should doctors discover an abnormality, the costs of follow-up testing and treatment can quickly soar into the thousands.
Without family planning centers as a resource, it's hard to find comfort in either result of a pap smear. Women may receive news that they've been healthy all along, making it easy to regret paying for an expensive test out-of-pocket, or they may discover a serious health issue they likely can't afford to treat. People already struggling to make ends meet will resist visiting the doctor if it means putting up rent money or a child's winter coat to pay the bill. The Governor isn't cutting the budget; he's gambling with the fate of women's health.
Without state funding next year, the centers would serve 40,000 fewer patients, leaving an already vulnerable population with even less. In the midst of a recession, these services are more critical than ever. The recently passed health care legislation may offer some assistance in the coming years, but it won't keep the lights on in the only medical centers serving neighborhoods that need them the most.
Making matters worse, the Christie administration also withdrew an application for a Medicaid waiver that would have allowed these clinics to expand services using federal dollars. Clearly, the governor's financial concerns tell only part of the story.
Denying access to health care is just another way of denying women the ability to participate fully in society. In 1992, Supreme Court Justice Sandra Day O'Connor acknowledged the link between reproductive rights and gender equality in an opinion that she co-authored, along with Justices Anthony Kennedy and David Souter.
"The ability of women to participate equally in the economic and social life of the nation has been facilitated," O'Connor wrote, "by their ability to control their reproductive lives."
The ACLU-NJ has fought for women's control of their lives since it began 50 years ago. We helped establish abortion rights in New Jersey before Roe v. Wade, defended a doctor in the early Seventies who was arrested under the state's obscenity laws for giving housewives information about birth control pills, battled farcical restrictions denying women tubal ligations and beat back countless restrictions on the right to abortion.
Christie's proposed cuts could make New Jersey -- a state known for its protections for women -- one of the least progressive states in the country, at least when it comes to taking care of our residents.
It will cost New Jersey -- and all of the other states -- far more in the long run, leaving a devastating impact on both the economy and society. For every dollar spent on family-planning services, the state saves four dollars in Medicaid expenses. If these cuts go through, only women wealthy enough to afford skyrocketing medical costs or those with stable jobs and good benefits will be able to see a doctor.
Adding a medical crisis to a budget crisis is no cure. It's bad public policy and a catastrophe for public health.