As former Speaker of the House
Thomas "Tip" O’Neill once said, "All politics is local."
That is certainly the case when it comes to reproductive justice.
While some states are blessed with pro-choice politicians, other states are controlled by anti-choice
politicians many of whom were elected to roll back any gains made in
the fight for reproductive justice. In addition to self-identified
anti-choice politicians, some pro-choice politicians may hold a different
definition of what pro-choice is and what requires defense. So, while
it may feel as if defending reproductive freedom is as simple as pulling
the lever for a self identified pro-choice candidate, not all pro-choice
candidates are the same.
Here in Missouri, anti-choice Governor
Matt Blunt is not seeking a second term, and the gubernatorial race is
wide open. While the Republican candidates debate who is more
anti-choice heading into their primary, the lone Democratic candidate,
Attorney General Jay Nixon, is campaigning for a win in November. The
Missouri House and Senate are currently under Republican control and
have produced anti-choice legislation with daunting regularity,
all of which our anti-choice governor has signed into law with glee.
So, pro-choice voters in Missouri have a huge opportunity
this year to elect a protective veto into the Governor’s mansion in
But nothing is ever as simple
as it first appears to be. Missouri’s social conservatism bleeds over into Democratic politics just as it fuels
Republican politics. It’s not unusual to hear a Democratic politician
referred to as a "pro-life Dem" or to see disappointing votes
show up in his or her record. Just because a candidate self-identifies
as pro-choice — and even if they take political heat for it — doesn’t
mean that a voter can assume he or she will defend choice once elected
Like any modern voter, I took
to the Internet to research Attorney General Jay Nixon’s stance on choice, hoping to find
an endorsement or two by a pro-choice advocacy group. But none
were to be found. When I did a search for news regarding Nixon
and choice, I found some alarming items
about his defense of anti-choice laws as Attorney General; for instance, while serving in the Missouri Senate in the 1980s, Nixon supported
a woman’s right to choose only in cases of rape or incest. A year ago, when defending himself against an attack ad,
the Nixon campaign responded by firmly stating the Attorney General’s
support of Roe v. Wade and his commitment to work with family planning
programs to promote sex education and contraception. But, as Attorney General, Nixon has also defended
Missouri anti-choice laws, such as parental consent and the infamous House Bill 1055 ambulatory surgical center law that would restrict a woman’s access to reproductive healthcare.
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Missouri Executive Director Pamela Sumners offers some clarification
on the race. Sumners shares that, although he did oppose abortion
except in cases of rape or incest in the 1980s, Nixon has been classified as pro-choice by NARAL since 1994. Sumners allows that Nixon’s
defense of anti-choice laws in his role as Attorney General does confuse
the issue and that we don’t exactly have a good barometer on him,
but added, "I can’t speak for Nixon’s campaign but I believe that
he would defend choice and I wouldn’t be prepared to vote for him
if I didn’t believe that."
And that quote sums
up where pro-choice voters are here in Missouri and throughout the country.
Unlike more liberal states where political support of choice is a given,
many states have conservative or moderate Democrats running for office
and those candidates may or may not be pro-choice. Even if they
are pro-choice they, like Attorney General Nixon, may have a political
track record that speaks to an evolution on the issue and raises concerns
about whether their position on choice depends on what the polls show.
If a pro-choice voter is lucky, she will be able to look to the endorsements by pro-choice groups who
vet and interview candidates to better understand their political position.
In the case of Attorney General Nixon, he has not formally sought the
endorsement of pro-choice groups. So this pro-choice voter is
left with little choice other than to vote for the candidate who may
or may not still have shades of gray regarding choice — or risk the possibility
of four more years of a guaranteed signature on anti-choice legislation
residing in the Governor’s mansion.
Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.
Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.
Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.
Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.
This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.
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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.
Where Funding Comes From
The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.
This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.
As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.
Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.
“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”
Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.
According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.
Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.
Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazettereported in April that at least some of the money appears to have been designated for programs outside the state.
Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.
“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”
“Every Other Baby … Starts With Women’s Care Center”
Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.
Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.
In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.
The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.
“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.
Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.
Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.
“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.
Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”
In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.
Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”
Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.
Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.
“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.
There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.
Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.
“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”
“Life Is Winning in Indiana”
Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.
These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.
Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.
A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”
Hunsberger denies any deceit on the part of Women’s Care Center.
“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”
Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”
“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.
Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.
“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.
If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.
In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.
Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.
“I will tell you that this has been the toughest year we have faced since I’ve been executive director of National Right to Life—and I came here in 1984—for our political fundraising,” David O’Steen announced at the annual National Right to Life Convention Friday.
Less than two weeks after the Supreme Court dealt the anti-choice movement its most devastating blow in decades, one of the nation’s leading anti-choice groups gathered at an airport hotel in Virginia for its annual convention.
The 46th annual National Right to Life Convention arrived at what organizers acknowledged was an unusual political moment. Beyond the Supreme Court’s decision to strike down abortion restrictions in Texas, the anti-choice movement faces the likely nomination later this month of a Republican presidential candidate who once described himselfas “very pro-choice.”
The mood felt lackluster as the three-day conference opened Thursday, amid signs many had opted not to trek to the hotel by Dulles airport, about an hour from Washington, D.C. With workshops ranging from “Pro-Life Concerns About Girl Scouts,” to “The Pro-Life Movement and Congress: 2016,” the conference seeks to educate anti-choice activists from across the United States.
While convention director Jacki Ragan said attendance numbers were about on par with past years, with between 1,000 and 1,100 registrants, the sessions were packed with empty chairs, and the highest number of audience members Rewire counted in any of the general sessions was 150. In the workshops, attendance ranged from as many as 50 people (at one especially popular panel featuring former abortion clinic workers) to as few as four.
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The attendance wasn’t the only sign of flagging enthusiasm.
“I will tell you that this has been the toughest year we have faced since I’ve been executive director of National Right to Life—and I came here in 1984—for our political fundraising,” National Right to Life Executive Director David O’Steen announced at Friday morning’s general session. “It’s been a topsy-turvy year. It’s been, for many people, a discouraging year. Many, many, many pro-life dollars, or dollars from people that would normally donate, were spent amongst 17 candidates in the Republican primary.”
O’Steen said the organization needed “$4 million that we do not have right now.”
When asked by Rewire to clarify details of the $4 million shortfall, O’Steen said, “You’re thinking this through more deeply than I have so far. Basically, the Right to Life movement, we will take the resources we have and we will use them as effectively as we can.”
O’Steen said the organization wasn’t alone in its fundraising woes. “I think across many places, a lot of money was spent in these primaries,” he said. (An analysis by the Center for Public Integrity found presidential candidates and affiliated groups spent $1 billion on the presidential race through March alone, nearly two-thirds of it on the Republican primary. Anti-choice favorite Texas Sen. Ted Cruz (R) spent more than than $70 million, higher than any other Republican.)
The National Right to Life Board of Directors voted to back Cruz in the Republican presidential primaries back in April. It has not yet formally backed Donald Trump.
“I really don’t know if there will be a decision, what it will be,” National Right to Life Committee President Carol Tobias told Rewire. “Everything has [been] kind of crazy and up in the air this year, so we’re going to wait and kind of see everything that happens. It’s been a very unusual year all the way around.”
Some in the anti-choice movement have openly opposed Trump, including conservative pundit Guy Benson, who declared at Thursday’s opening session, “I’m not sure if we have someone who is actually pro-life in the presidential race.”
But many at the convention seemed ready to rally behind Trump, albeit half-heartedly. “Let’s put it this way: Some people don’t know whether they should even vote,” said the Rev. Frank Pavone, national director of Priests for Life. “Of course you should … the situation we have now is just a heightened version of what we face in any electoral choice, namely, you’re choosing between two people who, you know, you can have problems with both of them.”
Another issue on the minds of many attendees that received little mention throughout the conference was the Supreme Court’s recent ruling in Whole Woman’s Health v. Hellerstedt, which struck down provisions in Texas requiring abortion providers to have hospital admitting privileges and mandating clinics meet the standards of hospital-style surgery centers. The case did not challenge Texas’ 20-week abortion ban.
“We aren’t going to have any changes in our strategy,” Tobias told Rewire, outlining plans to continue to focus on provisions including 20-week bans and attempts to outlaw the common second-trimester abortion procedure of dilation and evacuation, which anti-choice advocates call “dismemberment” abortion.
But some conference attendees expressed skepticism about the lack of any new legal strategy.
“I haven’t heard any discussion at all yet about, in light of the recent Supreme Court decision, how that weighs in strategically, not just with this legislation, but all pro-life legislation in the future,” Sam Lee, of Campaign Life Missouri, said during a panel discussion on so-called dismemberment abortion. “There has not been that discussion this weekend and that’s probably one of my disappointments right now.”
The Supreme Court decision has highlighted differing strategies within the anti-choice community. Americans United for Life has pushed copycat provisions like the two that were struck down in Texas to require admitting privileges and surgery center standards under the guise of promoting women’s health. National Right to Life, on the other hand, says it’s focused on boilerplate legislation that “makes the baby visible,” in an attempt to appeal to Supreme Court Justice Anthony Kennedy, who cast a key vote to uphold a “partial-birth abortion” ban in 2007.
When asked by Rewire about the effect of the Texas Supreme Court case, James Bopp, general counsel for the National Right to Life Committee, appeared to criticize the AUL strategy in Texas. (Bopp is, among other things, the legal brain behind Citizens United, the Supreme Court decision that opened the floodgates for corporate spending on elections.)
“This case was somewhat extreme, in the sense that there were 40 abortion clinics—now this is just corresponding in time, not causation, this is a correlation—there were 40 abortion clinics and after the law, there were six,” Bopp said. “That’s kind of extreme.”
Speaking to an audienceof about ten people during a workshop on campaign finance, Bopp said groups seeking to restrict abortion would need to work harder to solidify their evidence. “People will realize … as you pass things that you’re going to have to prove this in court so you better get your evidence together and get ready to present it, rather than just assuming that you don’t have to do that which was the assumption in Texas,” he said. “They changed that standard. It changed. So you’ve gotta prove it. Well, we’ll get ready to prove it.”