Take Charge

Take Charge is a state government program in Washington State started in 2001 under a waiver from the federal government's Medicaid program, under the George W Bush Administration. The purpose of the program is to reduce the number of births paid for by Medicaid by reducing the number of unintended pregnancies.

The program works essentially by providing free birth control, along with birth control information, to Washington State residents in an income bracket above that which qualifies for regular Medicaid (185% of median income) up to 200% of median income.

The program was a 5-year pilot program up for review and possible extension in June 2006. The program was approved for a 3-year extension by the federal government despite the fact that since the program's inception, the number of medicaid births has risen sharply, from just over 32,000 in 1999 to almost 39,000 in 2006 -- an increase of almost 7,000.



Consistently, the total amount of taxpayers' money paid through Medicaid for childbirth expenses has followed the same trajectory, from almost $190 million in 1999 to $290 million in 2006, an increase of $100 million.



It is conceivable that these trends could just mirror a pan-socioeconomic trend, that births are up across all demographic groups, but the data shows that these trends are mirrored by looking at Medicaid births as a percentage of total births:



In September 2006, the Washington Department of Social and Health Services published a final report of the project claiming it had been very successful.

The report claimed that the program was responsible for a 22% decrease in unplanned pregnancies among the targeted demographic, though this was extrapolated based on contraceptive usage, not actual differences in preganancies.

In fact, the program did not and does not measure the number of unplanned pregnancies, or abortions, amongst its clients, but rather "fertility", which means live births.

While it is not known conclusively whether or not the program has contributed to the rising abortion rates among lower income Washington residents, data shows that the number of abortions paid for by Medicaid, as well as the percentage of all Washington State abortions paid for by Medicaid, have followed a similar pattern as the data above.



One result of the program has been a doubling in clients and revenue of Planned Parenthood of Western Washington (PPWW), one of the primary partner agencies of the program. The program works through agencies such as local Planned Parenthood branches to reach prospective clients. PPWW reports that over 85,000 of its 150,000+ clients in 2005 were Take Charge customers. The following graph shows how PPWW's revenues have grown in recent years: