“1950, here we come.”
That’s the bleak outlook of many New Jersey women -- particularly Democrats -- as they lament the double assault by Gov. Chris Christie and the U.S. Supreme Court on women’s reproductive rights.
Although there have been a few legislative victories for them over the past several days, many women feel any gains are overshadowed by two irreducible facts: Christie’s refusal to restore funding to family planning centers and the Supreme Court’s Hobby Lobby decision, which lets private companies opt out of the Affordable Care Act (ACA) provision requiring them to supply all federally approved forms of contraception in their employee health plans.
On Monday, the day the Supreme Court released its ruling, Christie passed a budget for fiscal 2015 -- with a line-item veto to the Democratic majority’s $7.5 million proposal to fund the state’s “Title X” family-planning centers, which lost all of their appropriations from Trenton when he took office. The governor did leave intact increased funding for rape and domestic violence programs and maintained last year’s levels for breast and gynecological cancer screenings and treatment.
Now, his veto has led some women to worry that he won’t sign a separate bill to expand Medicaid coverage for family planning.
The governor didn’t take on reproductive rights in his veto message or answer questions from reporters after signing the budget. But he’s said in the past that the state can’t afford to spend on the clinics. Though his administration has focused new attention on safeguarding women from violence, he’s received a zero rating from NARAL Pro-Choice America and has made speeches in support of anti-abortion activists. That, plus his spotty legislative record on women’s issues, have earned him poor marks from women in and out of his party.
Democrats are accusing Christie of playing politics with women’s access to healthcare in order to curry favor with conservatives who are essential to his possible run for the 2016 presidential nomination.
“The battles I thought we’d fought and won -- apparently they’re not won in perpetuity,” said Sen. Loretta Weinberg, who issued the statement that today’s Republican agenda reminded her of the 1950s. “The fact that this is all still with us is very disheartening.”
Democrats didn’t expect Christie to leave family-planning funding in the budget, but his line-item veto troubled them nonetheless. During every budget cycle for the past five years they’ve included $7.5 million to help support the free and low-cost Title X clinics that provide birth control, STD counseling, pap smears, and mammograms to uninsured and low-income women, men, and teens. And every year since the governor first defunded the centers, which operate with private and federal grants and donations, he’s vetoed Democrats' attempts to restore the money.
The adverse effects, says Planned Parenthood Action Fund of New Jersey Executive Director Ed Remsen, still reverberate throughout the state.
“The pain hasn’t gone away,” he said, before noting that the elimination of state funding forced seven Title X clinics to close and others to drastically reduce their hours and staff.
Those who support the governor’s actions argue that patients of the closed facilities can simply patronize another one or seek services from either a family-planning center (similar name, different type of facility) or a community health center, both of which receive primary funding from the federal government.
But Remsen says it’s not that easy. In 2009, New Jersey’s Title X clinics (approximately 30 of which belong to Planned Parenthood) served more than 136,000 patients, 60 percent of whom used them for primary care. By 2012, roughly 35,000 of those patients had vanished from the system.
“We don’t know where they went,” he said.
But he can speculate why they left. In just three of myriad examples, a clinic in Hamilton switched to a fee-for-service model; Paterson’s clinic no longer offers prenatal care; and the Family Planning Center of Ocean County has increased its wait times for new patients from two to three days to two weeks.
What’s more, Assemblywoman Pamela Lampitt, who chairs the Committee on Women and Children, says low-income and elderly women now have a harder time physically accessing the more sparsely distributed clinics. She also notes that while every county has at least one federally supported community health center and one federally supported family-planning center that offer some of the same services, these facilities are often located in cities where suburban patients don’t feel comfortable.
“You’re not going to get a woman in Haddon Township to go into Camden to a federally qualified health center, but she would have gone to Planned Parenthood in Cherry Hill,” she said. The Cherry Hill office closed in September 2010.
According to the state’s Department of Health, six federal family-planning centers have also closed or merged since the end of 2010. Judging from the fact that the number of women seen at 105 community health centers increased by 51 percent between 2008 and 2013, it’s plausible that the majority of patients displaced by the closures are now receiving care at these facilities. But it’s equally likely that most remaining women are obtaining medical attention from emergency rooms or have dropped out of the healthcare system altogether.
Neither the family-planning centers nor the community health centers provide abortions. But 10 of Planned Parenthood’s 30-or-so clinics (of 58 total Title X clinics) do. And while, by law, federal money doesn’t fund abortion, pro-life advocates argue that dollars given to clinics that perform abortions enable them to redirect money that would have been used for other, less politically problematic, purposes.
The Guttmacher Institute think tank for reproductive rights reports that without Title X clinics, the number of unintended pregnancies in New Jersey would be 23 percent higher and the number of abortions would be 18 percent higher.
“By helping women avoid unintended pregnancies and the births that would follow, the services provided at Title X-supported centers in New Jersey saved $199.4 million in public funds in 2010,” read the institute’s State Center analysis.