The War on Planned Parenthood is in the States

Republican presidential candidate Senator Ted Cruz speaks at the "Women Betrayed Rally to Defund Planned Parenthood" at Capitol Hill in Washington July 28. Senate Majority Leader Mitch McConnell is planning to hold a vote on legislation on a Republican bill halting federal funding of Planned Parenthood, following the release of videos involving use of aborted fetal tissue for medical research. Carlos Barria/Reuters

Governor Scott Walker likes to brag that he defunded Wisconsin's Planned Parenthood, the reproductive health organization once again in Republicans' crosshairs, back in his very first state budget in 2011. But he didn't go as far as former Texas Governor—and current 2016 presidential rival—Rick Perry, who opted to block not just state funds but also federal Medicaid money for a health program for low-income women, rather than let those funds flow to Planned Parenthood in his state.

Now, conservatives in Wisconsin are also eyeing the federal Medicaid funds that go to their state's Planned Parenthood clinics. That's just one of several proposals Wisconsin lawmakers are considering to further rein in the nonprofit group, which is the nation's largest provider of abortions, among other services. And a spokeswoman for Walker signaled the governor also would be open to those new measures.

The Planned Parenthood funding fight brewing in Wisconsin is part of a broader, state-level battle over the organization that has been going on for years—long before an obscure anti-abortion group started releasing videos of Planned Parenthood doctors discussing harvesting tissue from aborted fetuses. Those undercover videos, obtained by the California-based Center for Medical Research, which opposes abortion, have shone a light on a grisly—though Planned Parenthood argues, perfectly legal—practice employed for medical research.

Amid the ensuing outcry, Republicans in Congress are drawing the lion's share of attention for their push to block Planned Parenthood's federal taxpayer funding (the federal government is barred from funding abortion but pays for other services the organization offers to low-income women). But it's conservative state leaders who have actually been successful at curbing taxpayer funds for the group. And with a Democrat in the White House to veto congressional proposals, that's bound to be true for these new defunding efforts as well.

"We'll see what happens at the federal level, but then we're working with our state allies and state legislatures to see which environments we can chip away at," says Mallory Quigley, communications director for the anti-abortion advocacy group Susan B. Anthony List.

Women's health advocates warn, however, that cutting funding to Planned Parenthood is limiting access to reproductive health services for states' low-income women, including cervical cancer screenings, STD tests and birth control. Democrats plan to use evidence of that to fuel their election-year narrative that Republicans are hostile to women, particularly in a presidential race that features six current or former GOP governors. The sitting governors, like Walker, also face mounting pressure from the right to prove just how tough they can be when it comes to restricting access to abortions or eliminating funding to organizations that perform them.

Walker's budget, signed into law in 2011, blocked state grant money from going to any health provider that offered or counseled about abortions, affecting Planned Parenthood clinics in nine counties. They "took away a million dollars from us," says Nicole Safar, director of government relations at Planned Parenthood Advocates of Wisconsin, noting that in eight of the nine counties, the Planned Parenthood clinic "was the only safety net provider," i.e. one where low-income women could get cheap or free health care services. Five of them have since shut down.

Now Wisconsin conservatives are eyeing the federal dollars, which Planned Parenthood's remaining clinics receive via grants and Medicaid reimbursements. State Rep. Andre Jacque, a Republican representing a suburb of Green Bay, is circulating two bills going after Planned Parenthood's two streams of funding from the federal government. He told the local press that together they would eliminate half or more of the funding each year that Planned Parenthood gets in Wisconsin.

In a statement, Walker's spokeswoman in Madison, Laurel Patrick, said the governor intends to work with the state legislature to put even more restrictions on Planned Parenthood funding. "While Governor Walker already defunded Planned Parenthood in Wisconsin, he supports additional changes to Wisconsin law to restrict federal funds that flow to Planned Parenthood as well," Patrick wrote via e-mail.

Walker isn't the only GOP governor talking tough on Planned Parenthood on the presidential campaign trail this year. New Jersey Governor Chris Christie makes sure to remind Republican primary voters that he's repeatedly vetoed Democratic legislators' efforts to include Planned Parenthood funding in the state budget. In Ohio, Governor John Kasich signed a state budget in 2013 that put Planned Parenthood clinics last in line to receive state grants, which, according to Northeast Ohio Media Group, "effectively prevents them from getting any of the funding."

But the state that's gone the furthest is Texas. Under Perry, the state blocked funding from its health program for low income women, largely funded by Medicaid, to go to Planned Parenthood clinics. The federal government argued that violated federal law and threatened to cut off Medicaid funds as a result. So Perry decided to bypass Washington and to instead fund the program entirely through state money.

Perry's assault on Planned Parenthood didn't stop there. In 2013, Texas passed a law requiring abortion facilities to meet hospital-style standards and abortion doctors to have admitting privileges at a nearby hospital. That law is being challenged in the courts. The distance women are forced to travel to access an abortion is a focal point of the case (a Wisconsin law requiring admitting privileges is also in the midst of a court battle). In May, the state of Texas passed a two-year budget that reorganized funding provisions for its Breast and Cervical Cancer Services program to put Planned Parenthood and other family planning centers last in line to receive the program's grants, effectively excluding them the same way Ohio did.

There is evidence that states' financial maneuvers against Planned Parenthood are limiting their female residents' access to reproductive health services. According to a study published in March in the American Journal of Public Health, a quarter of family planning clinics in Texas have closed since 2011 and the remaining clinics are able to serve 54 percent fewer women than were served before.

In a July 17 interview with Fox News Channel, Walker denied there's been a negative impact in Wisconsin. "Planned Parenthood, controversial though it is, helps a lot of women get birth control and prevent unplanned pregnancies," anchor Megyn Kelly pointed out. But Walker countered, "We took the money, we defunded PP, and we put it into other entities, in many cases we put it into county public health services. So there are better, non-controversial ways."

What Walker failed to mention was that his 2011 budget also cut the women's health grants by 10 percent, with the savings going to balance the state budget, a spokeswoman for Wisconsin's Department of Health Services confirmed. According to the Wisconsin Alliance for Women's Health, that cut was equivalent to a loss of $470,000. The state maintained the lower level of funding in the biennial budget it just passed this summer.

And a study by the Guttmacher Institute, which supports access to abortion, found that in Wisconsin, the number of women receiving publicly supported contraceptive services dropped by 24 percent between 2010 and 2013. That was less, however, than Texas (down 35 percent), Ohio (29 percent) and New Jersey (26 percent).

Safar of Planned Parenthood also notes that while the remaining funds got reallocated to other women's health services providers, none are located in the rural counties where the shuttered Planned Parenthood clinics were based. For the low-income women who relied on those clinics, the closest women's health center is now "sometimes 30 miles away, sometimes 60 miles away," she said. "The state certainly did not provide another option for those women."