Questions raised about Planned Parenthood cuts

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If federal funding for Planned Parenthood is blocked, could community health centers fill in the gap in services?

Senate GOP Leader Mitch McConnellMitch McConnellBill would require nominees to release tax returns Overnight Healthcare: House loosens pesticide rules to fight Zika | A GOP bill that keeps some of ObamaCare | More proof of pending premium hikes Senate votes to block financial adviser rule MORE (R-Ky.) argues it’s entirely possible, and the Senate is scheduled to vote on such a measure on Monday.

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Senate Republicans emphasize that while the bill would cut off roughly $500 million in annual funding for Planned Parenthood, it would redistribute the money to other groups, keeping overall funding for women's health at the same level. 

Republicans have seized on a series of controversial undercover videos that show officials at the abortion rights organization discussing the price of fetal tissue to argue that all federal funding should be cut off from Planned Parenthood.

But even members of McConnell’s party have their doubts that community health centers and other public health groups could fill the gap.

“The problem is, in my state and many others, Planned Parenthood is the primary provider of women's health services in certain parts of my state,” said Sen. Susan CollinsSusan CollinsGOP lawmaker: 'Republicans were wrong’ to block Garland Senate passes broad spending bill with .1B in Zika funds Senators unveil bill to overhaul apprenticeship programs MORE (R-Maine), who said she is likely to vote against the bill. “So I don't know how you would ensure that all of the patients of Planned Parenthood could be absorbed by alternative care providers.”

Planned Parenthood’s federal funding covers a variety of health programs for women, including family planning services such as birth control, and cancer screenings.

A 2012 study by George Washington University professors examined five counties in Texas and found that Planned Parenthood was the “dominant” provider in those areas. The study found that other clinics would need to increase their capacity by “two- to five-fold” in order to handle Planned Parenthood’s patients, but were already at or close to capacity.

“Planned Parenthood has become so dominant as a source of family planning that if you pulled it away, it would not be so easy to find places that provide those services as an alternative,” said Leighton Ku, a professor in the department of health policy at George Washington University, and one of the authors of the study.

Joseph Potter, a professor at the University of Texas, studies the effect of Texas’s exclusion of Planned Parenthood from the state’s health program for low-income women in 2013, and said the experience could be instructive.

“If there’s a lesson, it’s you can't just pull the plug on something and expect to recreate it seamlessly,” he said.

In less urban areas of the state like Midland, Texas, he said, Planned Parenthood was “virtually the only provider.” Some low-income women ended up being forced to stay with Planned Parenthood because there were no other options, and simply paid more for contraception out of pocket because state funding had been cut off, he said

Susan B. Anthony List, an anti-abortion group, counters that the number of people served by community health centers far outnumbers those served by Planned Parenthood.

According to the Government Accountability Office, the roughly 1,200 community health centers in the U.S. serve over 21 million people per year. Planned Parenthood, by contrast, serves 2.7 million people.

“These are comprehensive health care centers, something that Planned Parenthood is not,” said Mallory Quigley, a spokeswoman for Susan B. Anthony List.

Republican senators sounded similar themes.

For example, statistics compiled by Senate Republicans show there are 84 community health centers in Oklahoma, and six Planned Parenthood locations.

“So to say can they absorb this? Yes,” said Sen. James Lankford (R-Okla.).

Backers also point out that community health centers will be helped by the roughly $500 million in new funds. That would be a boost to the roughly $5 billion the centers currently receive in federal funds.  

“The funding is going to be directed to these community healthcare centers, so they would have additional funding which would help them to take in more patients,” said Sen. Deb Fischer (R-Neb.).

However, provider shortages could be a problem. Over half of Medicaid providers are not offering appointments to new enrollees, according to the Department of Health and Human Services Inspector General.

“Our concern in Indiana is we are in a provider shortage area,” said Kristin Adams, President and CEO of the Indiana Family Health Council, which administers federal funds for 35 clinics in the state, including Planned Parenthood.  The shortage would make it hard to find providers to make up for Planned Parenthood, she said.

As for absorbing the Planned Parenthood patients at other clinics, she said, “We would be able to cover some of them, but we have tried to space clinics out strategically, so it could be up to an hour or two drive to them.”

Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation, added that community health centers often do not provide as full a range of contraceptive services as Planned Parenthood does, including long-lasting methods like intrauterine devices.

“Some of them are at capacity, some of them also don’t provide the full range of services,” she said, noting that the feasibility of finding alternative providers could depend on where women live.

Making it harder to access Planned Parenthood could also have unintended consequences, said Potter, of the University of Texas.

“The net impact of reducing access to contraception is increased abortion,” he said.