Ohio Governor John Kasich recently signed a bill that will take $1.3 Million in federal grants away from Planned Parenthood and similar clinics across Ohio— following the wave of anti-abortion legislation brought on nationally in recent years by Republican legislatures. How will this legislation affect access to reproductive health care for women in low-income families in Ohio? Where will the money that used to serve Planned Parenthood go? And who pays for abortions, anyways?
In recent years, many states across the country have adopted laws that restrict access to abortion. Ohio, under Governor John Kasich, is no exception. Since taking office in 2011, Kasich has enacted several regulatory measures that restrict access— with the claimed intent of “protecting women’s health”. Most recently in February 2016, Governor Kasich signed House Bill 294, which will divert $1.3 million in budgeted federal grant money away from Planned Parenthood.
House Support
With the support of the Republican majority in the Ohio House, HB 294 made its way to Kasich’s desk in a 62-32 party-line vote (for a full list of voters in the House, see legislature.ohio.gov), and was signed by the Governor on February 21st, centering the conversation around the bill’s implications for access to reproductive health care, particularly for low-income women.
Following the Rules
A nontherapeutic abortion refers to a procedure where the life of the mother is not endangered by the pregnancy— even when the pregnancy was the result of rape or incest. Currently, under Ohio law, a pregnant woman will not have federal funding to support her in getting an abortion unless her life is in danger because of pregnancy complications.
The Federal law, known as the Hyde Amendment, already prevents federal dollars from going towards nontherapeutic abortions. And similarly in Ohio,
Revised Code Section 5101.56 mandates that state and local funds cannot be used for abortions, except in cases of rape, incest, or in cases where the pregnancy has left the mother in a “life-endangering physical condition”.
Video Fraud in Texas
Support for the bill gained traction last year when the infamous “Planned Parenthood abortion profit” video was released in Texas by two anti-abortion activists, David Daleiden and Sandra Merritt. In the video, the pair posed as a research company looking to illegally purchase fetal tissue from Planned Parenthood. After an investigation, a Texas grand jury cleared Planned Parenthood of any wrongdoing and indicted Daleiden and Merritt for using a fake government record “with intent to harm”.
Despite the findings of the Texas grand jury and the evidence of fraud on the part of the anti-abortion activists, John Kasich continues to site the video as one of his reasons for the defunding measures.
“They’ve lost credibility,” Kasich told CNN in a recent interview about Planned Parenthood. “We just can’t operate through that organization anymore. But we’re going to make sure that we have the places where women can go to get the treatment that they need.”
The most notable federal grant program that Planned Parenthood will no longer have access to the Title X Family Planning Program, enacted by Richard Nixon, intended to provide family planning and health services to uninsured and low-income families. According to the Kasich administration, “The Ohio Department of Health has at least 150 other sub-grantees and contractors for the affected grants and projects that address issues of infant mortality, violence against women, and minority HIV/AIDS.”
But the question remains— what are these sub-grantees and contractors? And what programs do they have in place to address these issues?
Moving Dollars to Federally Qualified Facilities
Dubbed the Planned Parenthood Bill, Ohio’s House Majority Floor Leader Barbara Sears (District 47, which includes Lucas and Fulton counties) explains HB 294 as “A prioritization bill on how we’re going to fund access to services.” She fully supports the bill, saying, “Quite frankly, this increases access (to health care) dramatically, because it moves these dollars over to our federally qualified facilities that can apply for the grant funding.”
Sears further notes that “We’ve been putting this money into 28 Planned Parenthood facilities around the state. Now, we have the ability to move these dollars to over 250 federally qualified facilities throughout Ohio. This will have the effect of increasing access in both urban and rural areas.”
Available Services Unsubstantiated 
.png)
But one local leader feels differently.
“She’s blowing smoke,” claims state representative Teresa Fedor (District 45). “The centers that she is talking about are fledging, and they were set up really quickly.”
“Low-income families are going to be adversely affected by this,” says Fedor. “Planned Parenthood provides preventative services and reproductive health care like birth control, cancer screenings, STD testing and treatment, and they offer many other reproductive health services— it’s a lot more than just abortions.”
According to their 2015 annual report, of all the services offered by Planned Parenthood, abortions are only 3% of the agency’s overall activity. “In fact, the government does not fund abortions,” said Fedor in reference to the Hyde Amendment.
Where Are These Other Facilities?
“Our brand-new site is right next to the Planned Parenthood building” says Doni Miller, CEO of the Neighborhood Health Association. This organization oversees more than ten locations around the city— a number of which are being consolidated as the new facility, Nexus Healthcare, slated to open this summer. The anticipated health center, at 1415 Jefferson Avenue, is literally across the street from Toledo’s Planned Parenthood, which sits at the corner of
Jefferson and 13th.
“We absolutely will fully consider the opportunity for funding when it becomes available. We serve, in essence, the same population, and we’ve been around for about 50 years,” says Miller. She encourages anyone in the community to reach out: “Anyone who wants to get connected with us or simply to tour the sites can call my office.”
According to Miller, they “have a really strong women’s health program, and we provide all of the services that Planned Parenthood does. The ability to pay is not a factor. We see absolutely anybody, whether they have insurance or not.” Unlike Planned Parenthood, Nexus Healthcare does not conduct abortions, but Miller notes that “our local Planned Parenthood doesn’t provide abortions either.”
What about other federally qualified Lucas County facilities? A dental clinic— Neighborhood Health Association Dental— a pediatric clinic— NHA Pediatrics; hardly the types of facilities providing services comparable to Planned Parenthood.
Limiting Physician Options
Kasich’s bill strictly prohibits the state from contracting services with any organization that performs or promotes non-therapeutic abortions, which means that “qualified facilities” could be defunded if they refer women to abortion clinics, or contract with a hospital or physician that provides abortions. This limits the scope of treatment for the patient, and limits a facility’s access to resources and doctors. Despite a doctor’s view on abortion, the options of physicians are held hostage by Kasich’s bill— a doctor simply cannot run the risk of losing funding because of a patient discussion covering all of her options
Additionally, some of these facilities do not have a certified OB-GYN healthcare provider on site, do not provide STD testing, birth control, mammograms, nor do they all accept Medicaid. While some of these facilities offer comprehensive care, including dental and vision, they do not provide the same scope and depth of women’s health care as Planned
Parenthood.
If the Government Doesn’t Pay for Abortions, Then Who Does?
“If a woman wants an abortion she needs to pay for that on her own,” says Nicole Evans, marketing and communications director for Planned Parenthood of Greater Ohio. “None of the funds that we receive from the federal government go to providing abortions. So, by cutting these funds, they’re not stopping or curbing abortions; what they’re doing is putting more women in Ohio at risk.”
The $1.3 million that Kasich will take away from Planned Parenthood, according to Evans, “was designated for educational programs, including breast and cervical cancer screenings, STD and HIV testing and treatment, our infant mortality program called Healthy Moms Healthy Babies, a personal responsibility program targeting youth, foster care, and judicial systems, and a VAWA (Violence Against Women Act) grant program that teaches young men and women about intimate partner relationships and setting boundaries.”
Planned Parenthood’s Impact on Toledoans
Four local women share their stories:
They helped give birth to a healthy baby. – Amanda Jo Miller
“I had never been to Planned Parenthood prior to unexpectedly getting pregnant at 22. I had just gotten out of a really bad relationship, and didn’t know what to do. The lady in the office literally held me while I cried…. They offered prenatal, OB/GYN, and adoption services information. [They] mentioned options, but abortion wasn’t even one of them. The compassion that I received from Planned Parenthood is really the thing that stuck out the most. Many people have a negative perception of Planned Parenthood, thinking that it’s only about abortions, but it is much more than that.”
A routine exam saved her life. -Megan Purtee
​
Without health insurance, Purtee accessed the services of Planned Parenthood. A few years ago, during a routine exam they found precancerous cells in her uterus:
“After finding some issues with my pap smear, they asked me to get a colposcopy,” says Purtee. “The staff there was very kind. They spoke with me about my options and their funding programs. I was able to get a procedure to remove the cells— which is very expensive without their funding programs.”
Her latest checkup was completely normal. Megan is thankful, saying, “It’s such a relief to have a place like this, and their yearly checkups are wonderful. Who knows what I would have done had they not been around. It’s possible that they helped save my life.”
Without insurance, she wouldn’t have found the cancer. -Kerri DeShetler
​
Last November, a pap smear revealed an abnormal biopsy that ultimately turned out to be early stages of cervical cancer:
“Planned Parenthood may have literally saved my life. I was kicked off my parent’s insurance when I was 19, and at the time, they were my only option for routine health screenings. Had I not been able to go there, I wouldn’t have had any other option,” says DeShelter. Thankfully, she now has health insurance and is able to treat the problem. But, had she waited until now to be screened? DeShelter says, “The cancer would be much worse. I trust Planned Parenthood. They’ve always been very compassionate with me, and they believe in what they’re doing. I’m just very upset that our political leaders are taking money away from them.”
Even with health insurance, the wait can be too long. -Erika Hennessey
“I did have health insurance, but to get put on birth control I had to see an OB/GYN. It was going to take three months to get in under my insurance provider. Planned Parenthood got me in the day that I called. It was amazing care. Honestly, it felt a little more comfortable because that’s what they specialize in. It wasn’t like at my doctor’s office where they couldn’t care less. What if I thought I had an STD or needed a cancer screening, and I had to wait three months before I could get tested? With Planned Parenthood, you can just make an appointment online, see someone the same day— and you don’t need to have insurance.”
Curbing the Infant Mortality Rate
According to the Center for Disease Control and Prevention (CDC), Ohio is ranked fourth highest, or worst, of the fifty states in infant-mortality rates.
“I don’t think that Planned Parenthood does anything to lower our numbers on infant mortality,” says Sears. “We’re already about the worst in the country, with respect to infant mortality. So why would we want to keep spending that money the way we are now when we’re getting such lousy outcomes?”
She also noted that $250,000 of the grant money is being earmarked for anti-smoking, birth-spacing, and safe sleep programs— all designed to lower the infant mortality rate in Ohio.
“Maybe we need to have a conversation about drug abuse, mental health, or the environment that the baby is being taken home to. Planned Parenthood doesn’t do that,” says Sears. “They help women take preventative measures and they offer health screenings, but they’re certainly not holding your hand when you’re in the delivery room, like they would at a federally qualified healthcare center.”
Planning for Parenthood
Contrary to Sears’ view, Evans, Planned Parenthood Executive, contends that Planned Parenthood does have such programs in place. Take, for example Healthy Moms Healthy Babies is “one of Planned Parenthood’s most impressive programs”, according to Evans. This program focuses on individually working with women before, during, and after pregnancy for up to two years.
“The program connects people with vital resources within their community— it’s like a personal concierge that really helps people through the process,” Evans explains. The infant mortality rate in Ohio is abysmal, and the money that’s being taken out of this program, in particular, is really an encroachment.”
Teresa Fedor believes that “We have the infrastructure in place with Planned Parenthood as a provider to families, and they’ve been uprooted with nothing substantial to provide the services in it’s place. The centers that she (Representative Sears) is talking about aren’t necessarily setup to handle these issues.”
Evans echoes this sentiment: “The reality is that this money comes from the Ohio Department of Health, through to Planned Parenthood. There is an aggressive and vigorous process that they use to identify the best provider of care that they’re looking for to fulfill their requirements, and year after year the Ohio Department of Health has decided that Planned Parenthood is the most strategically positioned healthcare provider to make the best use of those federal dollars. They haven’t said publicly exactly how they’re going to fill that gap.”
Some of these programs have been in place for almost two decades. According to Evans, “the question is, how is the Ohio Department of Health going to find a replacement? So far no one has been able to answer that question directly. It’s not as simple as reallocating the money to other entities, because those entities need to match or exceed the requirements for the grant set forth by the federal government.”
Calls to the Ohio DoH for comment to be included in this article went unreturned.
Will Planned Parenthood Stay Open?
The Toledo location, at 1301 Jefferson Avenue, along with the other clinics in Ohio will continue to offer their core services. None of the 28 Planned Parenthood facilities in Ohio will close because of the new law.
“The reality is that we’ll still be able to run our clinics. We’re still committed to doing what we do best which is providing reproductive healthcare to over 80,000 Ohioans every year. We will continue to do that through our health centers, though we won’t be able to do as much with our community outreach programs,” says Evans.
Without the grant money, Planned Parenthood will be cutting back on what appears to be the same kinds of outreach programs that the anti-abortion lawmakers are saying that we desperately need more of. Where exactly that money will go and how it will be used remains unclear.
For more information and to get involved with these issues,
visit the Planned Parenthood Advocates of Ohio website (ppao.org).
The National Provider Identifier Database (npidb.org), lists 294 federally qualified health centers in Ohio. Lucas County’s locations include:
- Cordelia Martin At Libbey*
- ​Cordelia Martin Health Center*
- Daisy Smith Community Health Center*
- Huron Women’s Clinic*
- Mildred Bayer Clinic*
- ​Navarre Park Family Health Center
- Neighborhood Health Association Dental
- Nexus Healthcare
- NHA Pediatrics
- River East Community Health Center
- Southside Community Health Center
- Toledo Lucas County Health Center
Of these clinics, only the Toledo Lucas County Health Center, Nexus Healthcare and the Huron Women’s Clinic offer the services of a certified OB-GYN healthcare physician. Most of these clinics offer the NHA’s “Women and Children” program, which includes nutritional support for pregnant women and young children– but does not offer OB-GYN or pharmacy services. While many of these centers offer medical care, they do not all offer services specific to women’s health.
All of these facilities, except for the Toledo Lucas County Health Center,
are operated by the Neighborhood Health Association of Toledo.
*Within a two-mile radius of Toledo’s only Planned Parenthood clinic.
