Cuts to Planned Parenthood have troubling impact on states
The political fight over the funding of Planned Parenthood could be felt in rural Scott County, Ind., where this year there was a rush to get HIV tests after 180 people tested positive. But there was no place to get testing services.
The area’s sole HIV testing center closed its doors in 2013 during an early campaign against Planned Parenthood.
The organization was then attacked by conservatives who rallied against the clinics’ sporadic practice of performing abortions. The clinic in Scott County did not perform abortions.
All summer, Planned Parenthood has been criticized after undercover videos showed staff members talking about fetal tissue donation, the sale of which is illegal. Planned Parenthood said the videos were heavily edited and denied any wrongdoing.
But a firestorm erupted and now conservative Republicans on the Hill are following Indiana’s lead. They say they will not vote for a federal budget that includes any Planned Parenthood funding.
The first of what is expected to be several congressional hearings on Planned Parenthood practices was held last week, with strong statements from both sides of the aisle.
“I really regret that these lawmakers want to insert themselves into what should be a sacred issue in women’s lives,” said Betty Cockrum, president and CEO of Planned Parenthood of Indiana and Kentucky.
Cockrum added that the political debate has hurt women in Indiana, which already ranked poorly in offering reproductive health services. In 2011, state lawmakers passed a bill defunding Planned Parenthood. The move later was found unconstitutional by the courts.
But Indiana lawmakers have continued to slash various sources of Planned Parenthood funding at a time when the cost to operate a medical facility is rising.
The Indiana Legislature has also restricted access to birth control and blocked comprehensive sex education in its schools.
Cockrum said that if those efforts were embraced, Planned Parenthood could help reduce the number of abortions.
She added that many women in the state, particularly the poor and those who live in rural areas and struggle with reliable transportation, do not know where to find affordable birth control, preventive care or simple accurate medical information. There are no other clinics to pick up the slack, she said.
A recent report prepared by the Guttmacher Institute found that Planned Parenthood clinics constitute about 10% of all publicly funded family planning centers, but provide care to about 36% of those seeking family planning services.
They also serve 37% of clients in a federal family planning program, although they account for only 13% of those clinics.
The Guttmacher report, requested by the Congressional Budget Office, also showed that one-fifth of all counties with a Planned Parenthood facility had no other safety net family planning clinics.
“And even where there are other safety net providers, they, on average, serve far fewer contraceptive clients than do sites operated by Planned Parenthood,” according to the report.
In Louisiana, Republican Gov. Bobby Jindal, a 2016 presidential candidate, has tried to end the state’s Medicaid contract with its two Planned Parenthood clinics, which also do not perform abortions.
His administration’s argument rests on a provision in state law that allows cancellation of a Medicaid provider agreement with a 30-day notice.
The Justice Department called that claim “wholly without merit,” saying Louisiana cannot rely on a state law to justify Planned Parenthood’s ouster,
A recent report by the Guttmacher Institute found that Planned Parenthood clinics comprise about 10% of all publicly funded family planning centers, but provide care to about 36% of those seeking family planning services.
but must show that the clinics aren’t able to perform Medicaid services or properly bill for them. Federal courts have overturned previous attempts in Arizona and Indiana to disqualify Planned Parenthood from receiving Medicaid reimbursements.
Jindal said that other clinics could make up for services lost from the closed Planned Parenthood locations in Baton Rouge and New Orleans. Those sites saw nearly 10,000 patients last year, most of whom were low income.
Lawyers for Louisiana said 2,000 family planning providers in the state were available to pick up Planned Parenthood clients, but their list included dentists and a plastic surgeon. A new list had 29 providers, not all of whom provide contraception, and many of whom had long wait times.
A 2012 Government Accountability Office report found that 38 states reported difficulty in finding providers that accepted Medicaid. Some specialists, including gynecologists, were particularly elusive.
In Texas, legislators slashed funding for all family planning clinics by 70% in 2011. Although some of the money was restored, families still have trouble finding care, said Jose Camacho, executive director and general counsel for the Texas Association of Community Health Centers.
“It destroyed all services for women,” he said.
Also in 2011, the state took over the Texas Women’s Health Program and banned Planned Parenthood from participating. A Texas Health and Human Services Commission report from January found that the health program served 30,000 fewer women after Planned Parenthood clinics were cut.
The states losing access to the services that Planned Parenthood provides aren’t generally known for good health. Texas ranks 31st among the states in overall health, according to a study by the United Health Foundation. Large swaths of the state are even designated as Health Professional Shortage Areas. In 2012, Texas had the second highest syphilis rate in the nation.
Indiana ranked 41st in that United Health Foundation survey of overall national health. Louisiana was 48th.
None of those states chose to expand Medicaid eligibility under the Affordable Care Act.
Advocates for the organization say there are few other providers offering Planned Parenthood’s services.
In fact, on some occasions, hospitals have come to rely on Planned Parenthood clinics to provide services they cannot or will not provide. In 2011, Swedish Medical Center in Seattle helped finance a new Planned Parenthood clinic next to the hospital because of its pending agreement with a Catholic health system.
A report by the American Civil Liberties Union and Merger-Watch found that in 2011, about 1 in 9 hospital beds in the country were in a Catholic-sponsored or affiliated hospital, many of which have tight restrictions on the reproductive health services they provide.
The attention and anger targeted at Planned Parenthood might be keeping some away from the clinics that do remain open.
Last week, a flammable object was thrown through the window of a clinic in Washington. No one was injured in the fire, but a Planned Parenthood spokeswoman said the damage will keep the center closed for some time. The organization hopes to have a temporary location identified soon.
But with more congressional hearings on the horizon, the ire surrounding Planned Parenthood is not likely to end soon and could even worsen.
House GOP leaders, who said they likely couldn’t overcome the predicted presidential veto of defunding Planned Parenthood, added that they don’t want to see a stalemate lead to a government shutdown. A budget agreement needs to be reached by the end of the month.
During last week’s hearing, Republicans said no funding should go to the organization, especially when other needs haven’t been met.
“This is a question of priorities. I’d like to know what your priority is. Planned Parenthood or feeding hungry children?” Rep. Jim Sensenbrenner (R-Wis.) asked one of the witnesses.