Let’s say you have a doctor’s appointment. You get in your car or on the bus or subway and head over, looking at your watch to keep time. Now you’re there. Almost. You can see the building, but you can’t get inside. Hostile people with signs are crowding your path. You force your way past the congestion and rattle the doors; they’re locked. Through a web of legislation, members of your state and federal government have caused the clinic where your doctor practices to close, restricting your ability to access the healthcare you need. It’s like being in a terrible, frustrating dream. Except, for many women visiting Planned Parenthood facilities, it’s reality.
These roadblocks don’t mean all is lost. Women — doctors, volunteers, people just like you — are doing their part every single day to keep the doors of Planned Parenthood clinics open, despite potential defunding.
“This is the second day that I’ve gotten through without crying,” Alyssa Miller, director of public affairs for Planned Parenthood Hudson Peconic, told me over the phone. She is one of many women involved with Planned Parenthood who I spoke to following news of the presidential election about what it could mean for the nonprofit healthcare organization. This kind of conversation opener was common in the various interviews I conducted for this piece. Moods were somber, the future uncertain, yet a sense of optimism pervaded. One thing was clear: of the employees and volunteers I interviewed, all testified that being a part of this organization — whether filing papers, passing out condoms, escorting patients or providing medical services — offered a sense of purpose. None of the women were stymied, none were hopeless.
2.5 million men and women in the United States visit Planned Parenthood affiliate health centers each year. Abortions make up 3% of the services offered. The remaining percentage includes birth control, STI/STD testing and treatment, breast and cervical cancer screenings and prevention, pregnancy testing, HIV testing and counseling, HPV vaccines, prenatal services, family practice services, adoption referrals to other agencies and hormone therapy for transgender patients.
Backed by a GOP-led congress, President-elect Donald Trump wants to cut off Planned Parenthood’s federal funding. The final decision could come shortly after his inauguration, and would eliminate over forty percent on the nonprofit’s total budget. “[D]enying Planned Parenthood roughly $400 million in Medicaid funds would take effect immediately,” reports the Chicago Tribune. Planned Parenthood receives more than $500 million in federal funding a year, 75 percent of that from Medicaid reimbursement for health care services provided to poor and low-income patients. To put that number into perspective, the federal government spent $845 billion on Social Security in 2014.
According to Planned Parenthood’s 2014 to 2015 report, 24 percent of the organization’s funding came from “non-government health services revenue,” 27 percent came from “private contributions and bequests” and 6 percent was listed under “other.”
“Government funding — with federal dollars comprising the biggest portion of this part of the organization’s budget — are absolutely critical to Planned Parenthood’s total operation,” wrote Janell Ross in a 2015 Washington Post article.
Adrienne Verrilli, Associate Vice President for Communications, Planned Parenthood NYC, is one of the many women I spoke with about Planned Parenthood’s current predicament. She stressed that the threat to defund Planned Parenthood “isn’t a left/right issue, it’s a health care issue.” Many times she assured me, “the public is behind us.”
“One in five women will visit Planned Parenthood in their lifetime,” she said. “The vast majority of the American people support this organization. They want to ensure that we continue to be a Medicaid provider. This includes Trump voters.” So long as abortions take place under Planned Parenthood’s roof, though, pro-life supporters will take issue with the organization’s federal funding — regardless of the fact that taxpayer money does not pay for abortion services.
According to Politico’s October 2016 report, “The 2016 Election: Clinton Versus Trump Voters on American Health Care,” a “majority (58%) of voters [ed note: meaning both Clinton and Trump supporters] favor continued federal funding of Planned Parenthood.” Politico also reported that a majority of voters (58%) oppose “allowing Medicaid funding to be used for abortion services.” (To be clear, the Hyde Amendment “currently forbids the use of federal funds for abortions except in cases of life endangerment, rape or incest. It has guided public funding for abortions under the joint federal-state Medicaid programs for low-income women.”)
At the end of December 2016, Texas Governor Greg Abbott formally announced his intent to remove Planned Parenthood from the state’s Medicaid program. The plan has been in the works for over a year; it could be enacted within the month.
Ken Lambrecht, Planned Parenthood of Greater Texas’s president and CEO, released a statement on the matter. “Texans deserve to decide where to receive their healthcare,” he said, “and for more than 80 years they have counted on Planned Parenthood of Greater Texas for that care. In the days ahead we will take every step necessary to ensure Medicaid patients can continue to count on Planned Parenthood for quality, accessible healthcare. In the meantime, our doors remain open for everyone, regardless of their income or insurance status, no matter what.”
His forward-marching attitude echoed that of the two New York-based and one Tennessee-based Planned Parenthood operations I spoke with in regards to “what Trump’s election could mean for them.”
“We lost Title X funding a few years ago,” said Dr. Sarah Wallett, Director of Medicine at Planned Parenthood Greater Memphis Region. “We made some adjustments and focused on different strategies. We worked on increasing the commercial insurance patients coming in the doors. We figured it out, and we stayed open. All of us are so committed to this work. There is only room for hope. We will continue to figure it out.”
Adrienne Verrilli was confident in PPNYC’s ability to withstand adversity, too. “There has been an outpouring of support from volunteers and donations post-election,” she said. “We’ve been overwhelmed by how many people want to help us during what is going to be a very trying time, but we’re in it for the long haul. Our doors are going to stay open no matter what.”
Alyssa Miller, the aforementioned Director of Public Affairs for Planned Parenthood in Hudson Peconic (who previously held the same job at Planned Parenthood in South Carolina), spoke about the supporters and volunteers who help the nonprofit’s doors “stay open,” and of those who physically walk Planned Parenthood patients to and from the front door, past protesters.
“I’ve seen a real commitment to our clinic escort programs,” said Alyssa. “Clinic escorts are dedicated to the patients who seek our services in areas where there’s a tangible, pervasive threat to their access to reproductive health. There is a next-level sense of ‘I’m here for you,’ no matter what. Truly. After the flood in Columbia, South Carolina, people were calling the office to ask when they could come back out to help.”
She spoke of how the escorts are there for both patients and employees. “Sometimes it’s the clinicians who need to hear, ‘I’m with you.’ They have to walk through protesters shouting things at them, too. Especially in places where people are not comfortable telling their families what they do, I can’t stress enough how much good it does someone who is used to protesters to then see someone who says, ‘Thank you.’”
Miller said that it’s never the escort’s job or goal to impress anything upon any of the patients. “We are there to listen if they want to talk and not impose our experiences on anyone in any way. It’s about recognizing everyone’s experiences are different and valid.”
A. Molloy*, a Planned Parenthood volunteer in Philadelphia, said that the clinic escort program taught her empathy. “The protesters make it so hard for these women. Patients have to walk through a crowd of mostly grown-ass men handing them some bullsh*t pamphlet. It’s sickening.” The program also taught her to never assume anything about other people’s situations. “All different kinds of people come here for all different reasons,” she said.
Grace*, a New-York-based writer, has participated in a variety of Planned Parenthood volunteer levels, from office administrative tasks (“lots of filing”) to escorting. She was a clinic escort during protests against Planned Parenthood in Columbia, Missouri. “That’s the most charged and fraught [way to volunteer] because you feel the passion against you. It can feel like a powder keg when people are yelling at you.”
She also stressed the sense of community she felt, and the benefits of taking part in such an organization. “Volunteering is effective protesting,” she said.
“Escorting can be challenging,” said Kristi Mahoney, a volunteer at Planned Parenthood in Boston, Massachusetts. “I have a lot of opinions, but I can’t rile up the protesters. You’re there to make patients who are walking in and out feel as comfortable as possible. College students who pass our clinic say the things to protesters that I wish I could say. They high five the escort volunteers. They remind you that not everyone is there to protest women and their decisions.”
Sarah Cyr-Mutty, also a volunteer of Planned Parenthood in Boston, told me that when she first started clinic escorting, there was a buffer zone that prohibited protesters from getting within 35 feet of building. In 2014, the Supreme Court struck it down, “ruling that the law infringed upon the First Amendment rights of anti-abortion activists.”
“Legislation in Massachusetts worked quickly to get a new bill that gives police the right to disperse people if they’re blocking door access,” she said.
Cyr-Mutty stands by the First Amendment, “but it felt like the right to access health care was being shadowed by the right to yell opinions in other people’s face. Part of ‘accessing health care’ is about how easily you’re able to physically get in the door. That often gets overlooked.”
“I literally ‘work for the man’ in a terrible industry,” a Planned Parenthood NYC volunteer named Jamie told me. “So many people get to make a difference through their work. This allows me to help make a difference with what I’m able to give. It’s also a great way to learn about health, reproductive justice and other topical issues. That’s my favorite part: I’ve learned so much, which you then spread to the community.”
She said something interesting, too, something that I’d been thinking about in terms of the volunteer/patient dynamic. Everyone who spoke about escorting — or volunteering at Planned Parenthood in general, really — was careful to point out that they were not there to save anyone, just as much as they weren’t there to judge. Jamie, who is part of the organization’s sex-education program in addition to escorting, stated it so clearly: “This idea that Planned Parenthood exists for a woman in need is a wrong way to think about it. Planned Parenthood’s goal is for every woman, every person of every gender, to have a healthy relationship with their sexuality and access to healthcare.”
Dr. Gillian Dean, the Physician Director of Clinical Research at Planned Parenthood of New York City, elaborated on Jamie’s point. “Planned Parenthood takes care of all women, not just women who need a safety net. Women of diverse backgrounds and ages and insurance coverage plans and income and education levels turn to Planned Parenthood to receive personal, compassionate, evidence-based sexual reproductive health care.”
Like many of the women I spoke to, Dr. Dean is concerned for what the political future could hold in terms of patient access to healthcare — the “implications of legislative assault on abortion access that don’t just affect Planned Parenthood, but other health centers.” She’s worried about low-income women’s access to reproductive services. “My primary concern is that women get the care they need,” she said.
Dr. Dean has always been open about her involvement with Planned Parenthood, but after the shooting at Planned Parenthood in Colorado, she decided to be more vocal. “One way to deal with fear and danger is to say, “I do this work. I am proud of what I do. Abortions are a normal part of healthcare, and this is the way that I am taking care of my patients. And not to leave it to a few brave soldiers, but to get more and more of us who provide abortions to say ‘I’m proud of it.’”
Normalizing comprehensive reproductive health care is part of Dr. Sarah Wallett’s mission as well. She noted that abortion is not the only reproductive service stigmatized.
Wallett and Aimee Lewis, the Vice President of External Affairs at Planned Parenthood Greater Memphis Region, told me of their affiliate’s program Free Condoms Memphis, which distributes 500 thousand condoms a year. Lewis said that since its inception in 2013, the program has had a real success normalizing sex-positive condom usage within the once-resistant, conservative city.
“We need to not be afraid to talk about these kinds of issues,” she said.
There was a moment in my first conversation with Adrienne Verrilli that felt like the terrible drop following a sugar rush. I’d spoken to so many women over the course of researching this piece who inspired me to take real action, to get angry, to do something, (to write this), that for days I was running on fire. Then I let myself ask, “But what if…” What if Planned Parenthood actually loses federal funding? What if those patients who rely on Medicaid can no longer access the health care they need? What if abortion is made illegal?
“We’ve been here 100 years and we’re not going anywhere,” she said to me. “We’ve fought many a battle, including the ones just to get ourselves open in 1916. Does that mean we might look a little different in the next few years? Maybe. No matter what, we will be moving ahead to make sure people are getting the care they need, when and where they need it. There’s a resounding force in the community and overwhelming support by the American people. We have the strength to push forward, and the will. We’re not rolling over.”
*A single asterisk indicates where names have been abbreviated or changed