The 50th state marked the 50th anniversary of legal abortion last month. Half a century ago, the newest state in the union was the most progressive on abortion rights, allowing safe and legal access three years before the U.S. Supreme Court’s Roe v. Wade decision legalized care for the rest of the country.

Fast forward 50 years, and you will see despite our progress, we are still in the fight to maintain support for the most basic reproductive health care because of massive budget cuts to family planning programs.

This is why it is so important our state Legislature reconvene — remotely — to pass a supplemental budget and fully fund family planning.

Pandemics have a way of clarifying systems and our way of life. COVID-19 has put us face-to-face with the reality that our health care and economic well-being are vital to life and prosperity. Hawaii’s Legislature is grappling with an answer to how to protect both: whether to fully fund family planning or not.

They must allocate at least $2.4 million for family planning services to keep the programs afloat. It is literally a matter of life or death for many people in Hawaii.

photograph Cory Lum/Civil Beat
The seal of the state’s high court, located at Aliiolani Hale. Hawaii recognized abortion rights before the U.S. Supreme Court did. Cory Lum/Civil Beat

Family planning programs provide essential health care through contraception, testing and treatment for sexually transmitted infections, cancer screenings and general wellness care. Fully funding these programs will stimulate the state’s economy by generating cost-saving health care for families and the government.

For every dollar spent on family planning programs, taxpayers save almost $7 because providing preventive care avoids the need for more expensive treatment and management down the road. Family planning also increases economic security by helping people pursue an education, get and keep jobs, and support their families.

Life-Threatening Conditions

Without access to affordable or no-cost sexual and reproductive health care, people in Hawaii may be forced to delay care or forego care altogether.

Life-threatening conditions such as cancer and pelvic inflammatory diseases will go undetected and untreated. When STIs go undiagnosed, the symptoms can lead to more serious infections that require costly emergency treatment and can even lead to infertility.

Fully funding a state family planning program will ensure all people in Hawaii, but especially low-income and uninsured individuals, get the health care they want, need, and deserve. Amid the devastation of COVID-19 and subsequent unemployment and health insurance losses, our most vulnerable communities seek to protect their long-term health and economic security.

If these were normal times, this year’s 50th anniversary of legal abortion would be worth reflecting on and celebrating the fact that the nation’s 50th state leads the country in ensuring all people in Hawaii are able to access reproductive health care, including abortion, for the next 50 years, and beyond.

We must protect the legacy and future of our state.

But these are not normal times.  We are facing one of the greatest public health crises of our time, which has exposed weaknesses in our health care system that we have long been fighting to fix. Our Legislature has an opportunity to lead by investing in family planning funding.

Let us not forget that the Trump administration caused this funding shortage when it passed a federal gag rule forcing health care providers to unethically misinform women about abortion or lose Title X funding. Title X funds family planning and related preventive health services, prioritizing the needs of low-income families and uninsured people.

Hawaii joined 21 other states to challenge the gag rule and Hawaii’s governor was one of the first to openly oppose the rule. Yet, the state has not allocated enough funding to replace the funds lost by Title X in this legislative session’s supplemental budget.

If the Legislature does not fully fund the state program, safety net providers and abortion providers may be forced to see fewer patients, lessen hours, or reduce costly services like long-acting reversible contraception, which is the most effective form of birth control.

While we recognize these are challenging times requiring hard decisions, Hawaii must protect long-term, adequate family planning to ensure our communities keep themselves healthy and plan for their futures, particularly during this time of crisis. We must protect the legacy and future of our state.

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