Planned Parenthood has a simple mission: We provide comprehensive sexual and reproductive health care services while protecting the privacy and rights of our patients.

But when you are dealing with the arcane and complicated system of health insurance in the United States, this is easier said than done.

Due to a combination of factors, family planning health care providers in Washington like Planned Parenthood are suffering financially right now more than ever before. 

At the beginning of the year, three of our health centers were forced to close because of chronic underfunding for patients who rely upon our state’s Medicaid program. And if something doesn’t change soon, even more health centers could close in communities across the state. 

The reason for these tough decisions is the antiquated Medicaid reimbursement rates for family planning services in Washington. Each time a patient with Medicaid walks through our doors, Planned Parenthood loses $167 on the visit.

Reimbursement rates are a long-standing issue for health care providers in our state. Washington has the lowest Medicaid reimbursement rates of our neighboring states, even lower than Idaho — a state that regularly attacks reproductive health care.

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It is difficult to talk about the funding it takes to deliver care when our mission is what drives Planned Parenthood, and drives me, but the losses are now so great that health care access is at risk. While we don’t expect to break even when serving our Medicaid patients, legislative action in Olympia can at least ensure that this disparity is reduced so that our doors can stay open. Our government leaders have been champions for Planned Parenthood and reproductive rights over the years — but rights without access are not rights at all.

Gov. Jay Inslee and the state Health Care Authority included a fix for Medicaid reimbursement rates in their December budget proposal, and now it is up to legislative leaders to build upon this and protect access to critical sexual and reproductive health care services.

Medicaid patients are disproportionately Black, Indigenous and people of color due to centuries of racist policies that have led to an extreme economic disparity. These patients rely on Planned Parenthood, and our peers like Cedar River Clinics and Public Health — Seattle & King County, for essential family planning health care. Tragically, we know that Black women in Washington die from pregnancy-related complications at nearly three times the rate of white women, and American Indian or Alaska Native women die at nearly eight times the rate. These numbers can only begin to be addressed with compassionate, regular, preventive health care. And at Planned Parenthood, we know that 40% of our patients see only us for medical care. As providers, we must continue to be a resource in Washington communities to ensure equitable access to reproductive care.

At a certain point, every young doctor realizes just how much the insurance system in the United States can come between you and your patients. Our country’s health care payment system does not value reproductive health or preventive care — even though the data clearly demonstrates these services prevent disease, decrease mortality, prevent unintended pregnancies and improve people’s lives.

Instead, the health care reimbursement system rewards procedures and surgeries, but we know those are not the only ways to bring about health and wellness for our patients. I am urging our elected leaders to make this better for our patients by providing more parity in the state’s publicly funded family planning insurance. 

Without action, Washington will fall even further behind. Instead of letting that happen, we must enact a budget that reflects our commitment to family planning access, because we all have a responsibility to the people in our state who need care the most.