Is sex only for rich people?

Government spending on family planning offers a huge return on investment, not just for families but for the public. In 2010, every $1 invested in helping women avoid pregnancies they didn’t want saved $5.68 in Medicaid expenditures that otherwise would have been needed, according to the Guttmacher Institute. Once upon a time, both left and right understood this calculus. Title X, the federal family planning program that primarily serves low-income women (and whose funding has fallen 18 percent over the last decade, after adjusting for inflation) was passed under President Nixon with unanimous Senate support. Today this and other federal programs that democratize family planning (including the Affordable Care Act) are subject to constant gutting and mockery, with pundits referring to advocates of affordable birth control as “sluts,” and politicians asking why the state should be subsidizing “recreational” activities like sex.

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America is increasingly turning into a two-track society when it comes to fertility decisions, with high-income, highly educated Americans availed of better and more options (even, it turns out, employer-provided egg-freezing services); and low-income women drifting into childbearing that they themselves say they’re not ready for. Despite what opponents say, improving access to family planning services and reversible contraceptives is not about encouraging sex — biology takes care of this already — or that false boogeyman of sterilization. It is about giving low-income women the same control over when, and with whom, they have children, as is afforded to their higher-income sisters.

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