In a bracing piece in The Nation, Sharon Lerner explores, with her usual clarity, why it is that primary prevention--simple birth control--now seems so devalued. Read, scratch your head, and be concerned. Sigh.

Women currently account for 51% of the overall U.S. population, according to the U.S. Census Bureau. To be precise, there were 154,135,120 women and 149,924,604 men in the United States in 2008. We also know that women, more often than not, are responsible for making decisions about their families' health care.

While I think it would be hard to make the leap that 51 percent of the programs and benefits of health reform should be directly targeted toward women, it's not a stretch to argue that health reform should address the health care needs of women and their families. That includes pregnancy planning and prevention.

Unplanned pregnancies are closely linked to a number of negative health, social, and economic consequences. Family planning services--counseling, gynecological care and screenings, prescription drugs and devices, and related outpatient services--are a cost-effective way to make progress on preventing unplanned pregnancy and improving health outcomes for women and families. As such, family planning should be classified as a preventive benefit with the same cost-sharing protections afforded to other designated preventive benefits in any essential benefit package that is created within the context of health reform.

For health reform to work, it has to be meaningful for everyone, including 51 percent of the U.S. population.

Over the past several months Congress has been working at a fast pace to get comprehensive health reform legislation to the President's desk before the end of this year.

Two Senate committees are working on bills which they will ultimately merge into one and send to the full Senate for a vote sometime before Congress adjourns for the August recess.

Meanwhile, there are three committees in the House that are working on health reform. The House committees are collaborating to produce one bill, which is also expected to be voted on by the full House by early August. Broad outlines of a "Tri-Committee" draft bill were circulated last week.

Looking at the various draft proposals that have already been released, it is clear that Congress is making a historic effort to reform health care, as is the Obama administration. Yet with so many "big picture" issues to grapple with, like spiraling health care costs, access and affordability, employer mandates, taxing benefits, and whether to include a public plan option, it's hard to get Congress's attention on some of the "smaller issues," such as pregnancy planning and prevention. However, pregnancy planning and prevention affects the lives of most Americans who would benefit from health reform, and therefore, is very much a part of the "big picture."

One hundred days into his administration and it is clear that President Obama is ready to take up the important issue of teen pregnancy prevention and unplanned pregnancy with a sense of urgency and seriousness that it deserves. Nothing exemplifies this more than what we heard at NFPRHA's annual gala luncheon yesterday when Melody Barnes, Director of the White House Domestic Policy Council, spoke about the need to direct more resources toward programs and services that support women's health and access to family planning services.

The Obama administration has made a strong commitment to prevention and evidence-based approaches to reduce teen and unintended pregnancy and in turn the need for abortion. In establishing the White House Council on Women and Girls, President Obama will address these issues and many others affecting women and women's health. In her remarks, Ms. Barnes expressed concern about the number of teens who are having sex without using contraception and acknowledged how important it is for parents to have the tools to be able to talk with their teens--both girls and boys. In addition, she raised the importance of involving young adults, men and women, in conversations about taking personal responsibility for their physical and emotional well-being.

To advance its goals, the White House is meeting with organizations and people in communities around the country and across the political spectrum to learn more about what communities are doing and what works. Ms. Barnes expressed a strong interest in working in partnership with family planning and reproductive health care providers to ensure that all women, men, and families get the health care and services they need.

This bodes well for those of us interested in making a serious dent in reducing the high rates of teen and unplanned pregnancy in our country. The steps the administration is taking are very encouraging and promising if we are to improve the lives and future prospects of children and families, and to help ensure that children are born into stable families who are ready for the demanding task of parenting.

In a real life example of putting your money where your mouth is, the Colorado legislature passed and Governor Ritter signed into law a bill that would expand Medicaid to cover an additional 100,000 uninsured individuals in the state. Pending approval from the federal government, the state would impose a fee on hospitals to raise the necessary funds, which the federal government would then match, to cover the cost.

Why are we so concerned about what our friends in the Wild West are doing, you ask? Because Medicaid is by far the largest source of funding for family planning services in the United States--it accounted for fully 71 percent of all state and federal spending on family planning in 2006--and these publicly funded services are critical to our ability to reduce this nation's stubbornly high rates of unplanned pregnancy. Expanding access to family planning means better maternal and child health outcomes, significant savings for taxpayers and government alike, and reducing the need for abortion by preventing unintended pregnancy. But I'm preaching to the choir (and if not, here's a cheat sheet).

Read more about our love affair with Medicaid here.

When President Obama rolled out his budget blueprint yesterday, he said "we are making a historic commitment to comprehensive health care reform. It's a step that will not only make families healthier and companies more competitive, but over the long term it will also help us bring down our deficit."

We hope this critically important effort will include helping people plan for healthy pregnancies and avoid unplanned pregnancies (of which there are 3 million each year). There is abundant evidence that doing so will improve the health and well-being of children and families. And, study after study shows that it will also save money--for taxpayers and employers.

Should be a no brainer, right? Well, yes, but first our leaders need to get over two things: the fear factor and the joke factor. Family planning is more than mainstream: 98% of sexually active women use some form of family planning. It is a key part of women's lives and health. Consider this: the typical American woman spends five years pregnant or trying to become pregnant and three decades trying to avoid pregnancy.

And, it has broad public support: 88% of voters support women's access to contraception. In fact, a recent poll by Public Strategies Inc. found that 72% of Republicans and Independents favor legislation that would make it easier for people at all income levels to obtain contraception.  The American people get this and the President does too, which is why his budget takes an important step to help more states provide family planning through Medicaid.

So, enough of the talk show jokes and smirks. Let's get serious and help do something that is common sense, promotes responsibility, improves health, and saves money.