What would happen if the doors suddenly closed on the 650 health centers across the United States operated by Planned Parenthood?
It’s certainly a topical question with the introduction of a bill in Congress last week by two female Republican legislators.
The legislation would take away the $500 million a year the federal government provides for Planned Parenthood.
It would also repeal a law that prohibits states from defunding the nonprofit organization.
Those tax dollars represent about 40 percent of Planned Parenthood’s operating budget.
Even if that money wasn’t recouped, Planned Parenthood would probably still operate, albeit with fewer centers and a lower capacity.
However, what if opponents did achieve their ultimate goal of putting Planned Parenthood out of business?
Those opponents say women would be able to get services such as cancer screenings, Pap smears, and counseling by going to other community health centers.
Perhaps more importantly to them, women would have trouble finding a facility that performs abortions.
“They would have a difficult time getting an abortion and I would celebrate that,” Eric Scheidler, executive director of the Pro-Life Action League, told Healthline.
However, supporters of Planned Parenthood say hundreds of thousands of women would lose access to important reproductive and other health services. Even more would face reduced services.
In addition, they say, abortions would actually increase because the number of unwanted pregnancies would go up.
These cuts, they add, would come on top of the changes being sought by Republican leaders in the Affordable Care Act (ACA).
“The primary goal is to block all women from reproductive health services,” Terry O’Neill, president of the National Organization for Women (NOW), told Healthline.
What Planned Parenthood provides
When it comes to Planned Parenthood, opponents focus on the abortion services the organization provides.
Anti-abortion groups say Planned Parenthood performed 324,000 abortions in 2014.
Scheidler calls the organization “the nation’s largest abortion chain.”
He notes its clinics perform 35 percent of abortions done in the United States compared to 1 percent of all Pap smears and 2 percent of all breast exams.
“It’s what they specialize in,” he said.
Supporters of Planned Parenthood take a different view of the figures.
Overall, Planned Parenthood’s clinics see 2.5 million patients a year.
They note the organization’s clinics provide 360,000 breast exams and 270,000 Pap smears annually.
The clinics also perform 4.2 million tests and treatments for sexually transmitted diseases (STDs). That includes 650,000 HIV tests.
In addition, it provides 2 million people with birth control information and supplies.
They estimate Planned Parenthood helps prevent 579,000 unwanted pregnancies every year, and only 3 percent of its health services involve abortion.
“It is a vital and valuable resource for our adolescents,” Dr. Cora Breuner, a Seattle pediatrician, and chair of the American Academy of Pediatrics (AAP) Committee on Adolescence, told Healthline. “There’s quite a bit that they do that is not contraceptive.”
The question of federal funds
Planned Parenthood has been around for 100 years.
It began receiving federal funds in 1970. In 1976, federal funds were limited to services that are not abortion-related.
Scheidler said although the $500 million in annual federal funds aren’t directly used for abortions they keep Planned Parenthood in business.
“It helps keep the lights on,” he said.
Scheidler also believes Planned Parenthood is a corrupt organization, noting a Medicare fraud case in Texas the group settled in 2013, as well as the 2015 controversy involving undercover videos taken at a Planned Parenthood clinic.
He says the organization doesn’t deserve taxpayer money.
Supporters wholeheartedly disagree.
They say Planned Parenthood provides vital healthcare services and helps lower the cost of other tax-funded programs.
Public opinion appears to be on their side.
In a Quinnipiac Poll taken in late January, 62 percent of respondents opposed cutting off federal funds for Planned Parenthood. That rose to 80 percent when those questioned were told federal funds aren’t used for abortions.
Supporters say Planned Parenthood could operate without federal funds but not in the way they currently do.
“In the short term, it would be extremely damaging,” said O’Neill.
Amy Friedrich-Karnik, senior federal policy advisor for the Center for Reproductive Rights, told CBS News it would be difficult for an organization as large as Planned Parenthood to continue operating without that federal money.
“There would be a shift in how Planned Parenthood operates,” she said.
A world without Planned Parenthood
Scheidler and other abortion opponents reject the notion that women would have no other place to go for healthcare services without Planned Parenthood.
In a blog in the Washington Examiner, Sen. Joni Ernst (R-Iowa) and Rep. Diane Black (R-Tennessee), the co-sponsors of the bill to defund Planned Parenthood, said there are 14 federally qualified health centers (FQHC) for every one Planned Parenthood facility.
Scheidler said those and other centers can be found on the website GetYourCare.org.
He said his group supports giving every dollar taken away from Planned Parenthood to other healthcare providers.
“We don’t want to cut off one single woman from getting the services she has been getting from Planned Parenthood,” Scheidler said.
Officials at Planned Parenthood declined a request from Healthline for an interview, but their supporters say there is no way these other organizations could pick up the slack.
They note that 54 percent of Planned Parenthood clinics are in rural or underserved areas.
They add Planned Parenthood is the only safety-net family provider in 21 percent of counties where it operates.
About 65 percent of Planned Parenthood patients are 150 percent or below the federal poverty line.
About 60 percent are recipients of Medicaid or Title X programs.
In addition, they say, Planned Parenthood clinics have extended hours, same-day appointments, and shorter waits than other publically funded healthcare providers.
A report commissioned by the Congressional Budget Office estimated 390,000 women would lose access to services and another 650,000 would have reduced access within a year if Congress blocked Medicaid patients from Planned Parenthood.
O’Neill said some women would go elsewhere without Planned Parenthood but others wouldn’t. Some women would also forego preventative healthcare services such as cancer screenings.
“Many women would die unnecessarily,” she said.
In addition, O’Neill predicted there would be an increase in sexually transmitted diseases (STDs), maternal mortality, and infant mortality, as well as a decrease in “well woman” visits.
She added there would also be an uptick in unwanted pregnancies, leading to more abortions.
“Women aren’t going to stop having abortions,” she said.
She called anti-abortion groups’ claims that women would find care elsewhere as “alternative facts,” noting that dentist’s offices are listed on GetYourCare.org as healthcare providers.
Some women have been going public recently with their stories on how Planned Parenthood helped them in times of need.
Several testified late last month before Iowa legislators.
One woman said her doctor refused to prescribe birth control pills that could have helped her with an ovarian cyst, saying it was his religious belief that an unmarried woman shouldn’t have contraception.
In a blog on The Hill website, Jen. D. Rafanan, a board member of the Feminist Women’s Health Center in Atlanta, wrote about an “urgent reproductive health issue” she experienced in 2012 when her menstrual period wouldn’t stop.
The county health center didn’t have an available appointment for three months, so Rafanan went to Planned Parenthood.
“Before I went to Planned Parenthood, I felt helpless. Afterward, I felt like I had someone on my side,” she wrote.
Another woman posted a note on a Healthline social media page saying it was Planned Parenthood that helped to switch her from the pill to an IUD to alleviate chronic headache symptoms.
“I so appreciate their care and availability,” the woman wrote.
O’Neill said there are thousands of other stories like these.
As an example, she said a 16-year-old girl who wants to become sexually active can go to Planned Parenthood without worrying her confidentiality will be breached.
Breuner, of the AAP, said relationship counseling is one of the most important services Planned Parenthood offers to teenage girls.
She said girls, especially those from low-income households, can learn how a healthy relationship should function.
“The counseling can teach her how to say “No,” and how she should expect to be treated,” Breuner said.