Health Care

Yes, Community Health Centers Are a Better Alternative for Women than Planned Parenthood

Supporters of Planned Parenthood hold signs during a rally in Santa Clarita, California. (Andrew Cullen/Reuters)
Every proposal to defund Planned Parenthood is, in reality, a proposal to fund something better for women and families.

It has becoming increasingly clear in recent days that America’s abortion giant, Planned Parenthood, is desperate to obscure its emphasis on abortion and preserve unfettered access to state and federal tax dollars. Midday on Wednesday, picking up on an article that appeared at a website called Splinter, Planned Parenthood tweeted a map of Maine produced by my organization, the Charlotte Lozier Institute (CLI). The map showed exactly how many federally qualified health clinics (FQHCs) and rural health clinics existed in the Pine Tree State in 2015. Our count showed a total of 172, compared with only four Planned Parenthood clinics.

The problem, Splinter asserted and Planned Parenthood echoed, is that these 172 service sites included such things as homeless shelters and dental clinics. Well, a fair point, so far as it goes. But the article and the tweets cite data that are out of date and, moreover, miss the Maine forest for the trees. CLI’s initial state maps for 2015, the second-to-last year of the Obama administration, were created to show what we described in our infographics as “better health care alternatives” for women. If you are homeless, or a woman who wants dental care, these federally supported alternatives do matter.

The central thrust of our maps was that FQHCs had, and have, the capacity to support a much more comprehensive range of services than the geographically diffuse Planned Parenthood centers do. The congressional debate for the past several years — during which Congress placed a measure to defund Planned Parenthood’s Medicaid payments on President Obama’s desk, which he vetoed— is all about the content and dynamics of taxpayer-funded care for women. Congress has repeatedly indicated it does not wish to fund, subsidize, or encourage abortion. Women have repeatedly indicated, by their choice of providers, that they will migrate to care centers that can meet all of their (and their children’s) needs.

Planned Parenthood, in the meantime, has made clear that there is nothing it wants more than to carry out and encourage abortions. By any yardstick, this is where Planned Parenthood has staked its growth curve. At one time in its history, the group accounted for 10 percent of all U.S. abortions. Today it accounts for 35 percent. Of the services provided to women who enter Planned Parenthood facilities and learn they are pregnant, a full 96.5 percent are induced abortions — 321,384 in 2016–17 in contrast with just 3,389 adoption referrals and 7,762 “prenatal services.” This is a hyper-efficient abortion-delivery system, and as public-health experts James Studnicki and John Fisher demonstrated in a recent peer-reviewed article, it’s an efficiency that has produced 3 million more abortions than would have occurred since 1995 if Planned Parenthood had been reducing its abortion rate the way the rest of the U.S. market is.

But what about that troublesome map? Every proposal to “defund” Planned Parenthood is, in reality, a proposal to fund something better. In the case of FQHCs, congressional Republicans have repeatedly sought to redirect women’s health dollars to community health centers. The individual centers that receive additional funds under Medicaid and Title X will provide breast exams, Pap smears, contraception, and other women’s health services — without entangling the taxpayer in abortion, as does funding Planned Parenthood’s expanding abortion matrix. Community health centers have demonstrated a remarkable ability to increase capacity. They now serve as many as 25 million clients annually, up from 21 million in 2014. At the same time, even with more money than ever available to it, Planned Parenthood has seen its contraceptive services drop by 28 percent over the last five years.

Back to that map. Since 2015, CLI has repeatedly refined its analysis of the community health center universe. In line with their growing caseloads, the number of these centers continues to increase. Examining data from the Health Resources and Services Administration, CLI estimates the current total number of FQHCs and rural health clinic sites in Maine at 210. Counting school-based clinics that often do provide birth control — but excluding sites that are administrative; offer only dental care or another single service such as mental-health care; or are elementary schools, nursing homes, or homeless shelters — the 2018 count of community health centers for Maine is slightly smaller, but still a robust 156 sites.

Interesting things happen when the federal government sends a check and women have more options. Currently, Planned Parenthood sites remain at just four in the Pine Tree State, but nationally the group has closed more than a third — 341 — of its centers since 1995, a period during which its government funding has risen. Keeping tax dollars flowing to the faltering abortion giant is, of course, one option, but the idea that it is a better option than building out community health centers that can supply mental-health services, substance-abuse treatment, prenatal care, and other services women want and need is ideological.

While Planned Parenthood was tweeting out the article from Splinter, its allies at the American College of Obstetricians and Gynecologists (ACOG) were — if a report from MedPage Today is correct — spreading anew some decidedly false information about Planned Parenthood services. Quoting Dr. Hal Lawrence, ACOG’s executive vice president and CEO, MedPage’s tribute says that “Planned Parenthood provides 300,000 mammograms per year, 600,000 Pap smears, and all the contraceptive services.” The third item listed is true, but the actual number of Pap smears that Planned Parenthood performed in the most recent reporting year is just over 281,000. Mammograms? As a Washington Post fact check confirmed, and outgoing Planned Parenthood president Cecile Richards admitted in her September 2015 congressional testimony, Planned Parenthood facilities have no mammogram machines.

Richards has proven herself a capable leader, but she is not an M.D., despite ACOG’s billing of her as such in an online flyer for their national conference this week in Austin, Texas. ACOG found itself mired in a major Facebook tiff when a speaker at the conference suggested that the cure for the relatively high maternal-mortality rate in the U.S. was to avoid pregnancy in the first place. This insight was illustrated with one of those perennial industry favorites: an illustration of a dancing condom bearing a cartoon face with a big grin.

This was too much for one ACOG member, who joined hundreds of disparaging replies on the ACOG Facebook page and tweeted, “As an ACOG fellow & an OB/GYN, I’m disappointed. Telling people not to get pregnant isn’t the right approach to lowering maternal mortality, esp when we know it’s Black moms, low-income ppl, pregnant ppl w/addiction who are dying at disproportionately higher rates [sic].”

ACOG subsequently regretted the post on this serious and complex issue and wrote, “We hear you and we sincerely apologize for the misrepresentation of ACOG’s commitment to addressing racial disparities in maternal mortality and improving women’s health care overall.” It would be pretty to think so, but ACOG and Planned Parenthood evidently continue to believe that expanding abortion is the key to reducing maternal mortality. They oppose even the most modest limits on abortion — such as ending late-term procedures and protecting the disabled unborn, both popular restrictions — and they hold taxpayer funds hostage by scaremongering about an increase in abortions that they claim will occur if their demands for funding are not met.

Women deserve better — much better — than this. From Maine to Hawaii, the Trump administration has a chance to choose a better path. It should do so, and soon.