As the city-run Women’s Health Center in Bayonne, New Jersey, closed its doors last month for the final time, workers hauled away desks, cabinets and dozens of white boxes labeled “pregnancy tests” and “condoms.”
The clinic was one of six forced to close after Governor Chris Christie eliminated the $7.45 million in state funding for family planning last year. Christie, who opposes abortion, said the state could no longer afford it.
His fellow Republicans, energized by the November elections that gave them control of 29 U.S. governorships and 25 legislatures, this year have introduced a record number of measures restricting abortion. They are also cutting services that provide gynecological care, sex education and contraception to a population of predominantly poor women.
“People are so narrowly focused on restricting abortion that they can’t see that by eliminating funding to abortion providers, you are also eliminating funding to family-planning providers, because so often these services are intertwined,” said Elizabeth Nash, a policy analyst for the Guttmacher Institute, a New York research organization that compiles reproductive-health data.
‘Any Money Whatsoever’
On May 10, Indiana Governor Mitch Daniels signed a bill eliminating about $1.4 million in Medicaid funding to organizations that provide family planning and abortion, such as Planned Parenthood. Wisconsin Governor Scott Walker’s proposed two-year budget would eliminate about $3.8 million for family planning and let insurers stop covering prescription birth control.
In Minnesota, the Republican-controlled Senate’s budget proposal would “eliminate any money whatsoever toward family planning,” said Brad Biers, a Health and Human Services Committee administrator for the party’s caucus. “Republicans for the most part are against abortion, so right away we said, ‘Let’s look at this.’”
The plan requires approval by the Republican-controlled House and Democratic Governor Mark Dayton.
More than half the 1,007 bills related to reproductive health issues that legislators have introduced this year seek to restrict abortion access, according to the Guttmacher Institute. The record 570 measures include provisions that extend waiting periods, expand counseling requirements and prohibit private insurers from covering abortions.
The number of abortion bills creates a “most hostile” climate, said Nash.
Nearly half of U.S. pregnancies are unintended, according to the federal Centers for Disease Control and Prevention.
Planned Parenthood operated 865 health centers in 2009, according to its latest annual report. The New York-based organization provided contraception to 36 percent of its 3 million patients, testing and treatment for sexually transmitted infections to 31 percent, cancer screening and prevention to 17 percent and abortion services to 3 percent, according to the report. About 40 percent of its centers offered abortions, said Tait Sye, a spokeswoman.
A proposal to strip all funding from Planned Parenthood, which received $363 million in government grants or contracts in 2009, almost shut down the U.S. government this year. Federal law bars Medicaid funds from being used for abortion except in cases of rape, incest or when the life of the mother is endangered.
After Republican lawmakers failed to cut off the money, attacks have continued on the state level.
‘Money is Fungible’
Taxpayer money shouldn’t go to any organization associated with abortion, said Marie Tasy, executive director of New Jersey Right to Life, which championed Christie’s cuts.
“Money is fungible,” she said in an interview. “The money they’re using for family planning frees up other money to promote abortions.”
Stripping funding to any abortion provider or its affiliates means clinics that have never performed the procedure, such as Bayonne’s, will become collateral damage, said Nash of the Guttmacher Institute.
On May 11, a judge denied Planned Parenthood of Indiana’s request to block the law cutting off funding. The law also requires women seeking abortions to view fetal ultrasound imaging and bans most abortions after 20 weeks. Abortion services are available at four of the organization’s 28 locations in the state.
“Indiana is not eliminating any benefit,” Jane Jankowski, a spokeswoman for the governor, said in an e-mail. “Medicaid clients in need of family planning services will still get those services but will need to use an entity that does not perform abortions.”
Family-planning centers are the main source of health care for 60 percent of the women who use them, according to the Guttmacher Institute.
Cutting funds that prevent unintended pregnancy won’t prevent abortions, said Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy, a nonprofit group in Washington. Abortion opponents should be the strongest supporters of family planning, he said.
“If you reduce the number of unplanned pregnancies, you reduce the number of abortions,” he said in a telephone interview. “It’s a very simple calculation.”
Biers, the Minnesota Republican Senate aide, said by telephone from St. Paul that eliminating as much as $11 million for family planning will help the state close a $5 billion deficit.
Adding It Up
“If you’re trying to make a budgetary argument, you lose out, because family planning saves money,” Nash of the Guttmacher Institute said in a telephone interview. For every dollar spent on family planning, states save an average $3.74 on maternity and infant care, a 2008 study by the organization found.
In Texas, the House of Representatives on April 3 passed a budget that cut more than $61 million for family planning. The bill is in a conference committee that includes members of the Republican-dominated Senate and must be signed by Governor Rick Perry, also a party member.
Another Texas measure introduced last month by Republican Senator Bob Deuell of Greenville would exclude abortion providers and affiliates from the Medicaid-funded Women’s Health Program. It awaits a vote.
Janet Realini, a doctor and president of Healthy Futures of Texas, said the family-planning cuts would result in an estimated 284,000 fewer women served, 18,000 fewer men and more than 20,000 additional Medicaid-paid births. Her San Antonio-based organization works to reduce teen and unplanned pregnancies.
Limiting access to birth control will “not necessarily” increase unintended pregnancies, said Representative Jodie Laubenberg, a Republican from Rockwall.
“Sometimes when you have to pay for something, whether it’s $5, or on a sliding scale, even $30, you tend to take a little bit more responsibility for things, if you’ve got some skin in the game, excuse the pun,” she said by telephone.
Tasy, of New Jersey Right to Life, said that patients whose clinics close “can just go elsewhere.”
Michael Drewniak, a spokesman for Christie, said the family planning decision was strictly fiscal.
“This is about the budget, making the hard choices and responsible spending,” he said in an e-mail.
Paying for Pills
In Bayonne, patients visited the storefront center about 4,000 times a year, said Steve Gallo, a city business administrator assigned to coordinate the closure. It stopped accepting patients in February after the state cut $480,000 from its $650,000 annual budget.
Across New Jersey, state and federal money paid for the care of 131,000 people, according to Michele Jaker, executive director of the Family Planning Association of New Jersey. This year, that will drop by an estimated 35,000, she said.
In Planned Parenthood’s Hamilton clinic, about 55 miles (88 kilometers) from New York City, a month’s supply of birth-control pills now costs a uniform $20, after the end last year of a sliding scale that let some women pay nothing, said Xan Blake, who oversees that center and two others. The cost of pregnancy test visits, which can include a medical history review and counseling about options, has risen to as much as $120 from $28.
In Trenton, access to family-planning services was cut to three days a week from six, Blake said.
Frances Palm, executive director of the Somerville, New Jersey-based Women’s Health & Counseling Center, which doesn’t offer abortions, said office visits may decline 40 percent, or 2,000, this year compared with last.
Centers such as hers have been “lumped in” with Planned Parenthood, she said. “The misconception is that because you tell people about all their legal options, you are advocating for abortion.”