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  • Title: A benefit-cost analysis of family planning services in Iowa.
    Author: Levey LM, Nyman JA, Haugaard J.
    Journal: Eval Health Prof; 1988 Dec; 11(4):403-24. PubMed ID: 10312809.
    Abstract:
    An analysis of publicly funded family planning services in Iowa was undertaken to provide tangible estimates based on local data of the value of these services in averting unplanned and unwanted births to women who voluntarily use them. The study reports methods that can be applied by other states in evaluating their own family planning programs. Benefits were measured as the cost savings in public expenditures avoided by providing family planning services to low- and marginal-income women. Iowa data for AFDC, food stamps, and Medicaid payments were used to calculate benefits. The total benefit savings were adjusted to reflect the impact of family planning services on preventing births. The adjusted savings were accrued over one-year and five-year time frames and for four age groups (14-19, 20-29, 30-34, and 35-44). In the base year, the cost of providing family planning services in Iowa to the more than 56,000 women who used them was $3.1 million, or $59 per user. Results showed that the benefits of family planning services were highest for teenagers who would become eligible for public assistance programs upon the birth of a child. This benefit-cost analysis of family planning services in Iowa weights primarily tax-financed family planning services against tax-financed income transfer programs (Medicaid, Aid to Families with Dependent Children [AFDC] and food stamps). The study reveals that benefits of family planning services are costs for 14-19 year olds and 20-29 year olds already receiving AFDC, food stamps, and Medicaid. Overall benefits decline over the 4 age groups, e.g., 14-19 year olds-19.37:1; 20-29 year olds-7.46:1; 30-34 years olds-3.14:1; and 35-44 year olds-2.11:1 all based on 5 year cost savings. The 1 year benefit-cost ratio shows, however, that for women over 29 the family planning benefits are costs (30-34 year olds-.93:1 and 35-44 year olds-.64:1). Costs averted for teenagers based on 5 year projections are greater by a multiple of 6.6 over their 1 year savings (1 year-2.95:1; 5 year-19.37:1) compared to a multiple of approximately 3.3 in the remaining age groups. The study also demonstrated that for those women who presently do not receive family planning benefits but who would receive public assistance at the time of birth of after birth are much those who already receive income assistance and Medicaid, e.g., 5 year benefit-cost ratio for 14-19 year olds-36.70:1 (delivery reimbursement not included) and 37.38:1 (delivery reimbursement included). Except in the short term for women over 29, the benefits of family planning in Iowa outweighs the costs. The benefits to taxpayers comes in supporting family planning services to teenagers, especially those of marginal income for whom the birth of a child would almost certainly mean dependence on public assistance.
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