Republicans insist other clinics could fill the void, but experts say that’s easier said than done. Use our interactive map to see how many women access Planned Parenthood services where you live

Texas is defunding Planned Parenthood clinics. What if every state did?

Texas is defunding Planned Parenthood clinics. What if every state did?

Following a series of “sting” videos released this summer by an anti-abortion group, Republican lawmakers at both national and state levels have intensified calls to defund Planned Parenthood.

On Monday, Texas became the latest state to announce its intentions, the same day a federal judge ordered Louisiana – which cut funding to Planned Parenthood in August – to continue payments to the organization.

In Texas and elsewhere, many Republicans insist that other clinics – ones that don’t support abortion – could fill Planned Parenthood’s role as a major provider of reproductive health services for low-income women. But that’s easier said than done, according to a September analysis from the Guttmacher Institute, a Washington-based thinktank that focuses on reproductive health policy.

More than 6.5 million low-income women in the US visited publicly funded clinics for their birth control needs in 2010, the latest year for which detailed Guttmacher data is available. More than one-third of them (2.4 million) went to Planned Parenthood.

“What I think is being missed by those seeking to close Planned Parenthood is the critical role the organization has to play in the family planning safety net in this country,” said Kinsey Hasstedt, public policy associate at the Guttmacher Institute.

So-called “safety-net” clinics offer inexpensive (or free) contraceptive services to low-income patients using government funds. They are run by state public health departments, hospitals, community health centers, Planned Parenthood affiliates and other private organizations.

Although Planned Parenthood accounted for just 10% of safety-net clinics in 2010, the organization served 36% of patients.

“In some parts of the country, it’s really the only game in town,” Hasstedt said.

In 322 counties, Planned Parenthood served 50% or more of the low-income women who got birth control through government-funded clinics. In 103 of those counties, the organization served 100% of clients.

In Texas, the organization provided contraception-related services to more than 180,000 low-income women in 2010 and served a majority of such women in 13 counties.

The state slashed funding for family planning services in late 2011, a move that targeted Planned Parenthood and other abortion providers.

Counties in which Planned Parenthood serves 50% or more of all women who go to publicly funded clinics for birth control. Source: The Guttmacher Institute Credit: Nadja Popovich/The Guardian

Planned Parenthood received $450m in funds from the federal government in 2013 – 41% of its total operating budget for the year. Of that money, $390m came from Medicaid reimbursements for birth control consultations, STD tests, pap exams and other services provided to low-income women (and men). The other $60m came from grants through the Title X national family planning program, according to the Congressional Budget Office.

In recent months, House Republicans have repeatedly voted to cut off federal funds for all such services, though none of the bills have made it past the Senate so far.



Federal money is already barred from paying for abortions.



If defunding efforts were eventually to succeed, the CBO suggests that up to a quarter of Planned Parenthood’s low-income clients – more than half a million women – could have trouble accessing birth control.



Although congressional defunding efforts have subsided for now, state-level attacks on on Planned Parenthood and other abortion providers – such as those in Texas and Louisiana – have now taken center stage.

In Texas, as in Washington, Republican lawmakers argue that diverting grant dollars to other safety net clinics could help fill the gap in family planning services left by Planned Parenthood.

But if Planned Parenthood were to stop serving publicly funded low-income clients, “there would clearly be shortages of providers”, said Drew Halfmann, an associate professor of sociology at the University of California, Davis, who studies the politics of health and social policy.

“You can’t just cut out tons of providers and not have an effect on the consumer,” Halfmann said.

Some Republicans, including presidential hopefuls Jeb Bush and Ted Cruz, have pointed specifically to community health centers as an alternative to Planned Parenthood. But such clinics alone “don’t have the capacity to step up and fill the significant gap of women needing care”, according to Guttmacher’s Hasstedt – a view shared by other experts.

Although there were more community health center clinics across the US, they served fewer family planning safety-net clients than Planned Parenthood did in 2010 – 16% to Planned Parenthood’s 36%.

Removing Planned Parenthood from the picture would strain an already under-resourced family planning system.

Between 2010 and 2013 alone, the number of women who need publicly funded family planning services increased 5%, from 19.1m to 20.1m. At the same time, the number receiving care from safety-net clinics fell from 6.7m to 5.8m.

“Limiting access is the opposite of what we should be doing,” Hasstedt said.