Analysis Sexual Health

All Those Alternatives to Planned Parenthood? In Texas, At Least, They Don’t Exist

Andrea Grimes

Spending scarce time, money, and energy, Andrea Grimes goes on a hunt to find one of those many "alternatives" to Planned Parenthood anti-choicers claim will provide access to reproductive health care.  Problem is, in Texas they don't exist.

Update from the author, 3:30 pm, Wednesday, April 6th:

A number of folks have noted, after reading today’s article, that Dallas has a county hospital system–Parkland–that provides women’s health care to indigent, low-income and uninsured people.

That’s true, and it works fine–if you’re already a patient at Parkland Memorial Hospital or your doctor is affiliated with them. But I’m not. 

So I spent about 45 minutes calling around to the women’s health care clinics sponsored by Parkland, and didn’t have a lot of luck. Of the seven clinics that provide services to women like me–uninsured, not pregnant–three picked up the phone. Two could see me in May and one in July. Which could work for me–but I’m just one woman. Parkland is one of the busiest county hospital systems in the United States, and if the thousands of women who rely on Planned Parenthood have to switch to Parkland, we’re talking about an excessive burden on a (clearly) already overburdened county system. To my mind, Planned Parenthood remains a necessary resource for women.

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Before I met with Texas State Representative Dan Flynn last month during Texas’ pro-choice lobby day, I truly believed that even the most passionate anti-choice conservative couldn’t look me in the face and tell me they didn’t really care whether I got the reproductive health care I needed. Who would seriously tell me their religious beliefs are more important than making sure hundreds of thousands of women just like me—women with high-risk HPV–don’t develop cervical cancer?

But like I said, that was before I sat in front of Rep. Flynn, in his Austin office next to his model airplanes and elect-Dan-Flynn gum, and told him how I’d lost my job and my health insurance and needed regular, affordable pap smears to keep an eye on my pre-cancerous cervical dysplasia. I told him Planned Parenthood could provide low-cost paps, breast exams and contraceptives to keep me healthy despite my lack of insurance, and I believed they should continue to be funded by government family planning dollars. He scoffed, waving around a handful of papers—spreadsheets and maps, it looked like—and told me that Planned Parenthood was nothing but a tax-evading abortion machine (he knew because he used to be a bank examiner and had heard some things from some people) and there were so many other options besides Planned Parenthood in Texas. I should and could go to one of those, he told me, so we could spread some of the wealth around to these smaller providers. It would be very easy, he said.

I asked him if he could give me that list he had in his hand, the long list of places I could get low-cost reproductive health care without insurance near my home in Dallas. He glanced at the list and rattled off some names, something about Dallas Emergency Services and Dallas County Hospital District. He didn’t exactly wait for me to get out my pen and pad. I filed out of Flynn’s office with the rest of the women I’d teamed up with for lobby day feeling surprised and disappointed. But I still wanted (needed!) to know where those low-cost health centers were that Flynn had referenced, because I knew the Texas Legislature to be hell-bent on cutting the family planning funds that keep Planned Parenthood and clinics like it afloat.

Planned Parenthood or not, I’d still need well-woman exams, birth control pills and suchlike, and I wanted to know where I could get these things if I had to spend weeks or months scraping by on a freelancer’s salary without health insurance. So here’s what I did: I spent my own time, money and energy trying to find a health care clinic that anti-choice conservatives, legislators and organizations would approve of—namely, to find a Federally Qualified Health Center or “look-alike” center that, by virtue of federal grant funding, cannot provide abortion services except in cases of rape, incest or threat to a mother’s life, as dictated by the 36-year-old Hyde Amendment. (I know—that amendment also applies to Planned Parenthood, which only uses private, non-taxpayer funds for its abortion services at separate, privately-funded locations, but we’re talking about conservative ideology, not logic, so just go with me here.)

But I thought, I’ll play this game. If it turns out I was wrong—and I really thought maybe I could be, because how could it seriously happen that “pro-life” Texans didn’t want me to get cancer screenings?—I would be the first to admit that you can take Planned Parenthood out of the equation and still find easily accessible, low-cost reproductive health care in a sprawling metropolitan area like Dallas. But I wasn’t wrong. I was, maddeningly, right. Considering the rate at which conservatives are defunding family planning in my state, and for that matter, across the country, I’m very sorry about that. All of this is an ideological, not fiscally conservative, battle. After all, family planning saves taxpayers $4 for every $1 spent. But I was trying to work around family planning dollars, since conservatives seem to think they go straight to gleeful baby-killing cocktail hours, and stick with straight-up FQHC’s. If they’re lucky, Dallas women will be told what I was told: an appointment at an anti-choicer-approved FQHC might be available in May if I called back in three weeks—at a location two cities away and five miles from the closest bus stop.

Or women can call Planned Parenthood, like I did, at lunch time on a Friday, and be told that an afternoon appointment including a full pelvic and breast exam is available that same day for about $100 at a location a few yards from a major public transportation hub that I could easily reach in a half-hour or so. But I’m getting ahead of myself. You see, I first had to do a little divination to figure out where exactly anti-choicers wanted me to get my health care (besides not Planned Parenthood), since I couldn’t actually get any of them to pass along that list of their approved providers to me. First thing in the morning, the day after I met with Rep. Dan Flynn, I called and e-mailed his office. After a day or so, they got back to me and advised I contact the anti-choice religious groupTexas Alliance For Life for a list of alternatives to Planned Parenthood. I e-mailed the Alliance on March 10:

Hi, TX Alliance for Life – I was referred to you by the office of Rep. Dan Flynn. I’m looking for a comprehensive list of alternatives to Planned Parenthood–when I visited with Rep. Flynn this week he referenced a document that appeared to be just such a thing. Karah Carr, a legislative aide for Rep. Flynn, tells me the Alliance for Life provided it. I was wondering if I could get a copy of the same list? Thanks! Andrea

So, what’s today? April the something? I haven’t heard back from the Alliance yet. I’ve even been Tweeting at both the Alliance and Rep. Flynn asking for that list of providers that can they believe can give me the same or better care as Planned Parenthood.

But, nada.

I know Flynn and his conservative counterparts were very busy over the weekend deciding which Texans deserve health care (hint: it’s not women of reproductive age) but I hoped that at least in Flynn’s passion for defunding family planning, he’d develop a passion for helping women find health care providers he approved of. I was wrong about that one.

I posted about my travails on my personal blog, where I have a number of anti-choice trolls who are always more than happy to share their wealth of knowledge with me. There, someone from another anti-choice group eventually commented and told me they wouldn’t mind if I went to a Federally Qualified Health Center or “look-alike” center that offers sliding fee scales. And look, said the “pro-life” Texan, there are seven such centers in Dallas! So that’s what I did: Last Friday morning, I went out of my way to find a doctor based on the fact that some people have a personal dislike of Planned Parenthood for providing abortions–a safe, common and legal medical procedure.

It hardly felt like easy-access, low-cost health care. It felt more like coercion, and it was a hassle, and it forced me to make decisions about my own body and health care based on what other people—people who never met me, who are not medical professionals—think I should be doing based on their religious beliefs.

I found that list of FQHC’s—I am privileged to have a flexible work schedule, home phone and home internet access, so I didn’t have to take time off work to go to the public library and use a pay phone, and I didn’t have to sneak around on a conservative, religious or abusive family or partner–and started making calls. Most places I telephoned did not provide reproductive health care and instead focused on providing low-income housing, job training and addiction-recovery programs. A homeless shelter on the FQHC list did tell me I could get a free pap smear if I could prove I was homeless. I then got sidetracked looking into something called Project Access, a low-cost program that helps uninsured people who don’t qualify for Medicaid—but because I made more than about $20,000 last year as an unmarried woman without kids, I don’t qualify for that, either.

And the Texas Breast And Cervical Cancer Services, which is supposed to provide low-cost screenings for Texas women? It referred me to Planned Parenthood. So that was a no-go.

Back to the phones: a clinic close-ish to my home had no receptionist and a full voicemail. Another receptionist laughed at me because I’d been given the number for the county hospital front desk and told me to call a place called Los Barrios Unidos Community Clinic. When I called Los Barrios, I got an individual’s voice mail and had to take down another number to a switchboard, after which I was transferred to another voicemail that said the women’s health care folks would get back to me in 24 hours if I left my phone number. They’ve yet to call me. Later in the morning, I finally got through to the Los Barrios clinic in Grand Prairie, which is a western suburb of Dallas. They had appointments open in May, potentially, if I could call them back the morning of April 25th. There, a pap smear would cost me as little as $30, but maybe more depending on my income.

I made my last call to a Planned Parenthood clinic in central Dallas. The receptionist there told me they could schedule me that same afternoon for a full pelvic and breast exam. It’d be about $100, but there was a sliding scale. Without Planned Parenthood and family planning funding that funds actual medical centers—not crisis pregnancy centers or adoption agencies, as may happen in Texas after this year’s budget–poor, uninsured and under-insured women in my city do not generally have access to quality reproductive health care in any real way. They sit on waiting lists for weeks and months, and that’s if they can take time off work to do what I did: spend a morning surfing the internet, finding phone numbers and addresses of health clinics and hospitals, calling them only to be put on hold, laughed at or hung up on, and if they do find the a clinic, leaving a message in hopes of getting a return call to schedule appointment.

I’m not saying I tried my absolute hardest to find a reproductive health care provider that Texas anti-choice conservatives approve of. I could have called back the clinics I had to leave messages at, the ones that promised they’d get back to me in 24 hours. I could have spent another morning calling clinics in Fort Worth, Denton, Waco or Oklahoma City, to see if one of them could get me in for an appointment in the next two months. Of course, to visit those places, I’d be spending in gas what I’d be spending to go to a local Planned Parenthood here in Dallas. So there wouldn’t really be any money savings, there’d just be conscience-savings on the part of people who don’t really want to hear or care about my personal health unless I’m pregnant or might be pregnant.

Anti-choicers like Flynn and “pro-life” activists want me and women like me to jump through these hoops not because it’s medically safer for us to go somewhere other than Planned Parenthood, but because they don’t want women hanging out with anybody who provides a safe, legal and common medical procedure. And for what it’s worth, I imagine the anti-choice folks who told me to seek out an FQHC should know this: FQHC’s do provide referrals to abortion providers at their discretion, even though they don’t provide the procedure on-site.

Of course, once you get to the next level, here–after anti-choicers have first told you they don’t want to fund the abortion industry with taxpayer dollars–then it magically becomes about some pseudo- socialist ideal about spreading the health care access around, just like Rep. Dan Flynn told me in his office last month. Suddenly, all those things they told you about the abortionists and the dead babies goes out the window, because really, it’s about making sure the little guys get their fair slice of the pie.

Nobody knows these two excuses—barring taxpayer funding for abortion and spreading the health care wealth around–are straight-up lies better than the anti-choice movement members themselves. There’s a reason why anti-choice legislators and activists are so strong on these two talking points: they’re simply, plainly, not true. Taxpayer funding for abortion does not exist. It hasn’t existed for thirty-six years thanks to the Hyde Amendment. And we need only to look to Nebraska, where five babies have died so far this year because conservative lawmakers do not allow hospitals to care for undocumented immigrants, to know that spreading the health care wealth around to everyone is a total farce. Besides, wasn’t Jesus a capitalist, anyway?

Commentary Contraception

For Students at Religious Universities, Contraception Coverage Isn’t an Academic Debate

Alison Tanner

When the U.S. Supreme Court sent a case about faith-based objections to the Affordable Care Act's contraceptive mandate back to lower courts, it left students at religious colleges and universities with continuing uncertainty about getting essential health care. And that's not what religious freedom is about.

Read more of our articles on challenges to the Affordable Care Act’s birth control benefit here.

Students choose which university to attend for a variety of reasons: the programs offered, the proximity of campus to home, the institution’s reputation, the financial assistance available, and so on. But young people may need to ask whether their school is likely to discriminate in the provision of health insurance, including contraceptive coverage.

In Zubik v. Burwell, a group of cases sent back to the lower courts by the U.S. Supreme Court in May, a handful of religiously affiliated universities sought the right to deny their students, faculty, and staff access to health insurance coverage for contraception.

This isn’t just a legal debate for me. It’s personal. The private university where I attend law school, Georgetown University in Washington, D.C., currently complies with provisions in the Affordable Care Act that make it possible for a third-party insurer to provide contraceptive access to those who want it. But some hope that these legal challenges to the ACA’s birth control rule will reverse that.

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Georgetown University Law Center refused to provide insurance coverage for contraception before the accommodation was created in 2012. Without a real decision by the Supreme Court, my access to contraception insurance will continue to be at risk while I’m in school.

I’m not alone. Approximately 1.9 million students attend religiously affiliated universities in the United States, according to the Council for Christian Colleges and Universities. We students chose to attend these institutions for lots of reasons, many of which having nothing to do with religion. I decided to attend Georgetown University Law Center because I felt it was the right school for me to pursue my academic and professional goals, it’s in a great city, it has an excellent faculty, and it has a vibrant public-interest law community.

Like many of my fellow students, I am not Catholic and do not share my university’s views on contraception and abortion. Although I was aware of Georgetown’s history of denying students’ essential health-care benefits, I did not think I should have to sacrifice the opportunity to attend an elite law school because I am a woman of reproductive age.

That’s why, as a former law clerk for Americans United for Separation of Church and State, I helped to organize a brief before the high court on behalf of 240 students, faculty, and staff at religiously affiliated universities including Fordham, Georgetown, Loyola Marymount, and the University of Notre Dame.

Our brief defended the sensible accommodation crafted by the Obama administration. That compromise relieves religiously affiliated nonprofit organizations of any obligation to pay for or otherwise provide contraception coverage; in fact, they don’t have to pay a dime for it. Once the university informs the government that it does not want to pay for birth control, a third-party insurer steps in and provides coverage to the students, faculty, and staff who want it.

Remarkably, officials at the religious colleges still challenging the Affordable Care Act say this deal is not good enough. They’re arguing that the mere act of informing the government that they do not want to do something makes them “complicit” in the private decisions of others.

Such an argument stands religious freedom on its head in an attempt to impose one group’s theological beliefs on others by vetoing the third-party insurance providers’ distribution of essential health coverage to students, faculty, and staff.

This should not be viewed as some academic debate confined to legal textbooks and court chambers. It affects real people—most of them women. Studies by the Guttmacher Institute and other groups that study human sexuality have shown that use of artificial forms of birth control is nearly universal among sexually active women of childbearing years. That includes Catholic women, who use birth control at the same rate as non-Catholics.

Indeed, contraception is essential health care, especially for students. An overwhelming number of young people’s pregnancies are unplanned, and having children while in college or a graduate program typically delays graduation, increases the likelihood that the parent will drop out, and may affect their future professional paths.

Additionally, many menstrual disorders make it difficult to focus in class; contraception alleviates the symptoms of a variety of illnesses, and it can help women actually preserve their long-term fertility. For example, one of the students who signed our brief told the Court that, “Without birth control, I experience menstrual cycles that make it hard to function in everyday life and do things like attend class.” Another woman who signed the brief told the Court, “I have a history of ovarian cysts and twice have required surgery, at ages 8 and 14. After my second surgery, the doctor informed me that I should take contraceptives, because if it happened again, I might be infertile.”

For these and many other reasons, women want and need convenient access to safe, affordable contraceptives. It is time for religiously affiliated institutions—and the Supreme Court—to acknowledge this reality.

Because we still don’t have an ultimate decision from the Supreme Court, incoming students cannot consider ease of access to contraception in deciding where to attend college, and they may risk committing to attend an university that will be legally allowed to discriminate against them. A religiously affiliated university may be in all other regards a perfect fit for a young woman. It’s unfair that she should face have to risk access to essential health care to pursue academic opportunity.

Religious liberty is an important right—and that’s why it should not be misinterpreted. Historically, religious freedom has been defined as the right to make decisions for yourself, not others. Religious freedom gives you have the right to determine where, how, and if you will engage in religious activities.

It does not, nor should it ever, give one person or institution the power to meddle in the personal medical decisions of others.

Roundups Politics

Campaign Week in Review: Trump Selects Indiana Gov. Mike Pence to Join His Ticket

Ally Boguhn

And in other news, Donald Trump suggested that he can relate to Black people who are discriminated against because the system has been rigged against him, too. But he stopped short of saying he understood the experiences of Black Americans.

Donald Trump announced this week that he had selected Indiana Gov. Mike Pence (R) to join him as his vice presidential candidate on the Republican ticket, and earlier in the week, the presumptive presidential nominee suggested to Fox News that he could relate to Black Americans because the “system is rigged” against him too.

Pence Selected to Join the GOP Ticket 

After weeks of speculation over who the presumptive nominee would chose as his vice presidential candidate, Trump announced Friday that he had chosen Pence.

“I am pleased to announce that I have chosen Governor Mike Pence as my Vice Presidential running mate,” Trump tweeted Friday morning, adding that he will make the official announcement on Saturday during a news conference.

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The presumptive Republican nominee was originally slated to host the news conference Friday, but postponed in response to Thursday’s terrorist attack in Nice, France. As late as Thursday evening, Trump told Fox News that he had not made a final decision on who would join his ticket—even as news reports came in that he had already selected Pence for the position.

As Rewire Editor in Chief Jodi Jacobson explained in a Thursday commentary, Pence “has problems with the truth, isn’t inclined to rely on facts, has little to no concern for the health and welfare of the poorest, doesn’t understand health care, and bases his decisions on discriminatory beliefs.” Jacobson further explained: 

He has, for example, eagerly signed laws aimed at criminalizing abortion, forcing women to undergo unnecessary ultrasounds, banning coverage for abortion care in private insurance plans, and forcing doctors performing abortions to seek admitting privileges at hospitals (a requirement the Supreme Court recently struck down as medically unnecessary in the Whole Woman’s Health v. Hellerstedt case). He signed a ‘religious freedom’ law that would have legalized discrimination against LGBTQ persons and only ‘amended’ it after a national outcry. Because Pence has guided public health policy based on his ‘conservative values,’ rather than on evidence and best practices in public health, he presided over one of the fastest growing outbreaks of HIV infection in rural areas in the United States.

Trump Suggests He Can Relate to Black Americans Because “Even Against Me the System Is Rigged”

Trump suggested to Fox News’ Bill O’Reilly that he could relate to the discrimination Black Americans face since “the system [was] rigged” against him when he began his run for president.

When asked during a Tuesday appearance on The O’Reilly Factor what he would say to those “who believe that the system is biased against them” because they are Black, Trump leaped to highlight what he deemed to be discrimination he had faced. “I have been saying even against me the system is rigged. When I ran … for president, I mean, I could see what was going on with the system, and the system is rigged,” Trump responded.

“What I’m saying [is] they are not necessarily wrong,” Trump went on. “I mean, there are certain people where unfortunately that comes into play,” he said, concluding that he could “relate it, really, very much to myself.”

When O’Reilly asked Trump to specify whether he truly understood the “experience” of Black Americans, Trump said that he couldn’t, necessarily. 

“I would like to say yes, but you really can’t unless you are African American,” said Trump. “I would like to say yes, however.”

Trump has consistently struggled to connect with Black voters during his 2016 presidential run. Despite claiming to have “a great relationship with the blacks,” the presumptive Republican nominee has come under intense scrutiny for using inflammatory rhetoric and initially failing to condemn white supremacists who offered him their support.

According to a recent NBC News/Wall Street Journal/Marist poll released Tuesday, Trump is polling at 0 percent among Black voters in the key swing states of Ohio and Pennsylvania.

What Else We’re Reading

Newt Gingrich, who was one of Trump’s finalists for the vice presidential spot, reacted to the terrorist attack in Nice, France, by calling for all those in the United States with a “Muslim background” to face a test to determine if they “believe in sharia” and should be deported.

Presumptive Democratic nominee Hillary Clinton threw her support behind a public option for health insurance.

Bloomberg Politics’ Greg Stohr reports that election-related cases—including those involving voter-identification requirements and Ohio’s early-voting period—are moving toward the Supreme Court, where they are “risking deadlocks.”

According to a Reuters review of GOP-backed changes to North Carolina’s voting rules, “as many as 29,000 votes might not be counted in this year’s Nov. 8 presidential election if a federal appeals court upholds” a 2013 law that bans voters from casting ballots outside of their assigned precincts.

The Wall Street Journal reported on the election goals and strategies of anti-choice organization Susan B. Anthony List, explaining that the organization plans to work to ensure that policy goals such as a 20-week abortion ban and defunding Planned Parenthood “are the key issues that it will use to rally support for its congressional and White House candidates this fall, following recent setbacks in the courts.”

Multiple “dark money” nonprofits once connected to the Koch brothers’ network were fined by the Federal Election Commission (FEC) this week after hiding funding sources for 2010 political ads. They will now be required to “amend past FEC filings to disclose who provided their funding,” according to the Center for Responsive Politics. 

Politico’s Matthew Nussbaum and Ben Weyl explain how Trump’s budget would end up “making the deficit great again.”

“The 2016 Democratic platform has the strongest language on voting rights in the party’s history,” according to the Nation’s Ari Berman.