Working its way through the Ohio Legislature is a state budget bill that has major implications for the way family-planning services are provided. The Ohio budget contains language that puts family-planning clinics at the bottom of the list to receive funding.
Family Planning Association of Northeast Ohio operates several independent family-planning clinics. They do not provide abortions and have no affiliation with Planned Parenthood, but the clinics are still at the end of the line under a new tiered system because they give referrals.
Ahead of the facilities are local health departments, places like emergency rooms and free clinics. Family Planning's executive director, Mary Wynne-Peaspanen, says if there's any money left over — which she says is not likely — "then they could consider applications from independent, specialty clinics like my organization and like Planned Parenthood."
The budget bill from the Republican-controlled Legislature could well put the nonprofit out of business. Since 1970, it has served primarily low-income women, but it's facing an anticipated 40 percent hit to its funding.
"They've been very clear about the fact — at the General Assembly — that their target is Planned Parenthood. But that doesn't change the fact that there are other organizations that will be impacted by this funding," Wynne-Peaspanen tells Jacki Lyden, host of weekends on All Things Considered.
In Ohio and elsewhere, family-planning clinics typically provide a range of women's health services, like cancer screenings, blood pressure tests and contraceptive services.
Judy Waxman, vice president for health and reproductive rights at the National Women's Law Center, says the vast majority of women who are sexually active have used contraception at some point in their lives.
"So on one level, we as a nation have recognized that contraceptives are not only what everybody uses, but they also are very important for women's health," she says. "There is, however, a minority of politicians who try to use any issue related to 'sex' to make some kind of political hay out of it."
Waxman says a handful of states are looking at centers that receive Medicaid or state funding for family-planning services — and some are cutting the budgets. Those states include Indiana, Arizona, Wisconsin and now Ohio.
The Anti-Abortion Lobby
Michael Gonidakis is the president of Ohio Right to Life, one of the groups that lobbied hard for the current legislative approach. He admits the ultimate objective is a straightforward one.
"Our goal is to find a way to end abortion. Not make it illegal, but to end it," he says. "We're big proponents of adoption reform, foster care reform, and we want to find ways to continue to help women who find themselves in unintended pregnancy, to realize that they can have their baby, that there's support services there for them to keep their child."
He doesn't expect that women will have less access to family planning, not even those who are low-income.
"There's nowhere — and I repeat, nowhere — in the state of Ohio where there won't be other options in a very close walking proximity to ... a clinic that may go out of business," he says. "We're doing some good things here in Ohio, and there's access to these types of services and care for low-income women across the state."
But it still worries Jess Locher, a 28-year-old uninsured cosmetologist in Chardon. She went to the local branch of the Family Planning Association as a teenager. Ten years later, the mother of two still goes to the same clinic because she can't afford anything else.
"If they took family planning away, I wouldn't be getting the female care that I need because my job doesn't offer me insurance, so I couldn't afford to go to a gynecologist," Locher says.
Take Texas, For Example
Ohio is on the verge of making decisions that would alter the way family planning is funded. Texas started down this road two years ago.
"When the Tea Party wave came through Texas in 2010, there was a big movement to oust Planned Parenthood from all of the state health programs," says journalist Becca Aaronson.
Aaronson, who covers health care for the Texas Tribune, says state lawmakers took a three-pronged approach to cutting family-planning funds. They cut family-planning funding, then set up a tiered financing system prioritizing comprehensive health clinics. Third, they prohibited any group affiliated with a provider that performed abortions from participating in the Medicaid women's health program.
More than 50 clinics throughout Texas closed their doors. As the dust settled, the consequences of this policy started to become apparent, Aaronson says.
"The state estimates that roughly 24,000 babies are going to be born as a result of these changes, and that's because women don't have as much access to birth control," she says.
The spike caused enough of a stir in Texas for state legislators to restore some of the funding to family planning.
"They decided to put an extra $100 million toward primary care for women's health, so that many uninsured women of all ages could get cancer screenings, diabetes treatment and family-planning access," Aaronson says.
Waxman of the National Women's Law Center considers the Texas legislation "a failure for women in the state."
"It's possible in some circumstances that women could go somewhere else, but many other health centers don't provide family-planning services because they know Planned Parenthood is available to do that," she says.
Waxman says the issue is an ideological one. "I can only hope that those people that are really outliers on this issue not continue to erode and really hurt the women in their states," she says.
Who's hurt and who's helped by laws on access to family-planning services is in part, of course, a matter of deeply held opinion and even religious faith.
In Ohio, Wynne-Peaspanen at the Family Planning Association is bracing herself.
"I've been with the agency for 27 years. And funding cuts happen and, you know, funding increases happen. But this is ... the most serious," she says.
Gonidakis from Ohio Right to Life says he's confident things will be just fine.
"I do not foresee any situation whatsoever where a woman's going to be denied services because of the availability of so many other clinics in the state of Ohio," he says.