Thousands of women across North Carolina could lose access to health care if Congress persuades President Donald Trump to halt federal Medicaid reimbursements to Planned Parenthood.
House Speaker Paul Ryan is leading a Republican effort to strip funding from Planned Parenthood as part of the process of dismantling the Affordable Care Act, known as Obamacare.
The century-old organization has long been a target of anti-abortion politicians because it provides abortion services through its health-care centers. But the bulk of what Planned Parenthood provides is preventive health care, including affordable birth control and screening for cancer and sexually transmitted diseases, which its officials say some patients would be hard-pressed to find elsewhere.
“You already have an overtaxed, overburdened public health care system in America, of which Planned Parenthood is a critical part,” said Jenny Black, president and CEO of Planned Parenthood South Atlantic, based in Raleigh. “When you take that away, the infrastructure is just not there to absorb those patients.”
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Ryan has said community health centers across the country would pick up patients now served by Planned Parenthood if the organization had to shut its clinics. A report by the Congressional Budget Office has estimated that about 400,000 patients would lose their care if the reimbursements are halted, and up to 650,000 more would have reduced access to care. The report said that thousands of unintended pregnancies would likely occur as a result, and many of the children born would likely be on Medicaid themselves.
North Carolina has dozens of health clinics that serve uninsured or under-insured patients. Many are non-profits, operate on part-time hours and rely on physicians and other personnel who donate their services.
Planned Parenthood operates more than 650 health centers across the U.S. that serve more than 2.5 million women and men each year.
The organization has nine clinics in North Carolina, from Asheville to Wilmington, serving about 25,000 patients each year.
Planned Parenthood does not release the number of abortions its doctors perform each year.
“Most of our services are preventive,” Black said, “but we’re proud to offer safe and compassionate abortion care as well. If that is the care that our patients need then we will make sure that we are there for them.”
Planned Parenthood does not receive direct budget appropriations from Congress. Federal money comes to the organization as reimbursement for medical services. Like any other provider, Planned Parenthood health centers treat patients and then bill each patient’s insurer, whether that’s a private company or Medicaid.
Nationwide, Medicaid reimburses more than $400 million for services rendered by Planned Parenthood each year, about half the organization’s revenue. By law, no federal funds are used to pay for abortion services. Planned Parenthood also receives federal Title X funds for low-income family planning and adolescent pregnancy prevention and care.
Medicaid uses federal and state funds, with states receiving reimbursements for much of their spending. If the federal government barred Medicaid reimbursements for services provided by Planned Parenthood, states could choose to pay for those services.
Ellen Powley, 25, has been a patient at Planned Parenthood’s Raleigh health center for more than two years. A transgender woman, she came to the clinic when she was ready to begin hormone treatments. She had insurance through her employer at the time, and it wouldn’t cover the cost of the treatments no matter where she went.
“I came to Planned Parenthood at a very vulnerable time in my life,” she said, so she was seeking a supportive environment. “It’s very scary to go into an office for the first time with something that most people have never even thought of before, and something that many people would judge me and look down on me for.
“It was nice to talk to a real professional about how these hormones would treat me.”
In addition to providing medical care, Planned Parenthood advocates on behalf of women’s issues and those of the LGBTQ community. Its attorneys in North Carolina, for instance, have fought additional restrictions on abortion in the state.
Since Ryan announced the renewed fight to withdraw Medicaid reimbursements, Planned Parenthood has seen an outpouring of support, with donations and social media-shoutouts coming from current and former patients. The organization estimates that 1 in 5 women in the country has used Planned Parenthood’s services at least once.
“That loyalty runs deep,” Black said.