Officials at Planned Parenthood say that thousands of women in the Hudson Valley could lose access to health services like cancer screening and STD testing if a provision in the American Health Care Act that would cut off Medicaid funding to the century old family planning organization becomes law.
The provision made it through the house version of the proposed Obamacare replacement bill championed by Republicans. It is now before the Senate where the bill is expected to undergo major revisions.
Pro-life advocates and their supporters in Congress have long sought to cut off all federal funding to Planned Parenthood. While Planned Parenthood officials say that abortion accounts for just three percent of services delivered at the organization’s health centers, it remains the nation’s single largest abortion provider. In 2014, according to Planned Parenthood officials 323,999 abortions were performed at its clinics. The same year, nearly three million people sought contraceptive services and more than 600,000 women received breast and cervical cancer screenings at the health centers. A 1970s era law, meanwhile forbids any federal funding, including Medicaid for abortion services.
That’s of little consequence to pro-life advocates like Barbara Meara, chairwoman of the New York State Right to Life Committee. Meara said that Medicaid and other federal funding of Planned Parenthood’s non-abortion services effectively subsidized the group’s efforts to provide low-cost abortions.
“The money is all fungible,” said Meara. “The bookkeepers keep (federal funding) clear of abortion services, but it still frees up money for abortion services.”
Planned Parenthood supporters are quick to point out that abortion services are provided at hospitals, clinics and private offices across the country that accept Medicaid reimbursement. None are threatened with the Medicaid cutoff. But Robin Chappelle Golston President and CEO of Planned Parenthood Empire State Acts — the group’s lobbying arm — conceded that the organization’s high profile advocacy on abortion rights had put it in the crosshairs of abortion foes.
“Nationally, Planned Parenthood has become a symbol of reproductive freedom and health,” said Golston. “We’ve become a kind of catch all and (the targeted Medicaid cutoff) is symbolic.”
Much more than just abortion services
Locally, Planned Parenthood officials say that the fight over abortion has the potential to disrupt critical health services at clinics that are, in many cases, the only option for low income women in underserved communities. Planned Parenthood of the Mid Hudson Valley operates health centers in Kingston, Poughkeepsie, Newburgh, Goshen and Monticello that see about 20,000 patients annually according to Francis Fox-Pizzonia, Vice President of Education and Public Affairs for the affiliate. Of those, about 60 percent use Medicaid to pay for their care. Its Kingston clinic is the only safety net family planning provider — a designation for federally funded clinics which offer a range of contraceptive option — in Ulster County. If the defunding proposal goes through, some 12,000 women in the region would have to find new providers. In Ulster County Medicaid patients can receive services similar to those available at Planned Parenthood at two clinics, the Institute for Family Health and Hudson River Healthcare that are geared towards low income, underserved populations. Former planned parenthood patients will also have the option of seeking care from private practice physicians who accept Medicaid. But Fox-Pizzonia said that shifting thousands of Medicaid patients to new providers would strain an already overburdened women’s health infrastructure. Nationally the American Congress of Obstetricians and Gynecologists has gone on record saying that existing providers would be unable to fill the void in the event Planned Parenthood was cut off from all federal funding.
Planned Parenthood, supporters say, often functions as a kind of urgent care provider for women’s health issues. One 2014 study found that 62 percent of Planned Parenthood clinics offered same-day appointments while 78 percent offered extended evening and weekend hours to serve working women with children. That kind of easy to access service, Fox-Pizzonia said, would likely become a casualty of defunding. “It would be pushing people further down the line, it’s (sexually transmitted diseases) not treated in a timely manner, it’s cancer not being detected as soon as it could be,” said Fox-Pizzonia. “We’d be talking about a public health crisis.”
Proponents of defunding argue that fears that women would be left without access to critical health services are overblown. Meara noted that there are 13,000 federally qualified health clinics that could pick up the slack. She also argued that Planned Parenthood was not nearly as critical to women’s healthcare as they portrayed themselves.
“They’re not doing as much as they tell us they’re doing,” said Meara. “They make it sound like no woman in America will get healthcare if they don’t get this money.”
The threatened cutoff in Medicaid funds has spurred intense lobbying and activism among Planned Parenthood supporters. Ulster County lies within the 19th Congressional District held by freshman Republican John Faso. Faso is on the record opposing the defunding provision and voted against it in committee. But since then he has cast three votes for versions of the AHCA that included it. When questioned, Faso said that while he disagreed with the defunding provision, he voted based on the totality of the legislation which he believes is needed to make health insurance more affordable. Those votes have drawn the ire of Planned Parenthood supporters and made pink “I stand with Planned Parenthood” signs and shorts ubiquitous at weekly protests outside his Kingston office. Earlier this month, Faso ran a gauntlet of pink-clad protestors at a senior citizens forum at the Kingston library. Earlier this month, the Planned Parenthood Action Fund deployed its National President and public face Cecile Richards to Kingston and Albany to highlight the potential impact of defunding in the 19th District.
“We think he’s not listening to his constituents,” Richards said at a roundtable discussion at the group’s Kingston clinic flanked by women who related stories of the importance of Planned Parenthood Services in their lives.
While the lobbying continues in hopes that the defunding provision will die in the Senate, Planned Parenthood officials say that they’re also preparing for the worst. Fox-Pizzonia said that short term plans called for Planned Parenthood clinics to continue serving Medicaid patients if the defunding provision takes effect in hopes that a swift legal response would result in a court order to restore the funding. If the ban sticks, officials said, it could eventually lead to scaled back hours and reduced staffing at clinics locally and nationwide. Golston expressed confidence that, in New York at least, elected officials would do what they could to mitigate a Medicaid cutoff. She noted that Assembly Democrats had voted to include emergency funding for the group in its latest budget while Gov. Andrew Cuomo had come out strongly against the defunding effort. But, she added, the proposed Medicaid cutoff still held the potential for major disruption in women’s healthcare across the state.
“We’re in uncharted waters now,” said Golston. “On so many issues.”