To hear Genevieve Plaster tell it, Planned Parenthood could close shop in Montana tomorrow with little consequence, though many women would disagree.
Plaster is senior policy analyst for the anti-abortion Charlotte Lozier Institute, an organization that has worked closely with U.S. Sen Steve Daines, R-Mont., and other Republicans in making the case for a post-Planned Parenthood America.
When Daines and Sen. Joni Ernst, R-Iowa, launched their plan Jan. 31 to defund Planned Parenthood, it was Lozier’s research that Daines relied on to assure Montana women that there are enough community health clinics providing health care to take the place of Planned Parenthood.
Lozier identified “130 Better Health Care Alternatives” to Planned Parenthood that already receive federal funding and do not provide abortions.
“These are health centers that are identified by the Health Resources and Services Administration that are licensed and eligible to receive Medicaid and Medicare reimbursements," she said. "They are identified as primary and preventative health care providers.”
Planned Parenthood is the nation’s largest women’s health network and receives roughly $500 million a year from the federal government for services other than abortion, for which it receives no federal funding. Abortion accounts for about 3 percent of Planned Parenthood’s services.
The list includes community healthcare mainstays like RiverStone Health, the designated healthcare provider for Yellowstone County. RiverStone is a family medicine primary care clinic that treats patients for all their medical needs, including all of the services provided by Planned Parenthood except for abortion.
But there’s one big difference between Planned Parenthood and RiverStone, said the clinic's CEO John Felton. “We do not anticipate being only the patient’s reproductive health care provider."
RiverStone wants to see its patients for everything. The patient who relies on RiverStone for long-acting reversible contraceptives, like an intrauterine device, is preferably using RiverStone for non-reproductive health issues. When it comes to scheduling non-urgent care, the wait for an appointment can be weeks. Planned Parenthood is more immediate.
“We are unique in our ability to provide Montanans same-day appointments, which many providers are unable to do, and we see every patient regardless of their ability to pay for the health care they need,” said Laura Terrill, Planned Parenthood of Montana’s vice president of external affairs. “There are provider shortages across Montana making our ability to see patients quickly and provide high-quality care essential to ensuring our communities remain healthy.”
Patients don’t come to Planned Parenthood to make a political statement, Terrill said. Taking Planned Parenthood away as a choice for political reasons is wrong.
Other care providers listed by Lozier include all 17 of Montana’s federal community health centers. These health care providers focus on providing care to uninsured and underinsured people usually living in poverty. The Montana Migrant and Seasonal Farmworkers Council in Billings is listed.
The argument against these centers picking up Planned Parenthood’s clientele is that they’re already maxed out.
Planned Parenthood has clinics in four Montana cities: Billings, Helena, Great Falls and Missoula. But the counties those communities are in represent 40 percent of the state population and serve the medical needs of surrounding counties, as well.
In 2014, Planned Parenthood of Montana served nearly 12,000 patients, nearly half of whom used federal assistance to pay for health care. Nearly 10,000 women received prescriptions for birth control through Planned Parenthood in Montana.
The 17 community health centers provided fewer contraceptive services combined than Montana’s Planned Parenthood clinics.
In 2010, half of the women in the state received contraceptive care through Planned Parenthood.
“I’m a woman that would be close to retirement age. I don’t know a woman my age that hasn’t used Planned Parenthood at some time in their life,” said Elizabeth Marum, of Belgrade. “And we use it for basic health care.”
Planned Parenthood has, for decades, been a safe harbor for women needing reproductive care, Marum said, in a way that more generalized clinics and rural care providers aren’t. It’s a place of medical privacy in a state where no degree of federally mandated confidentiality can fully pull the curtain between the personal goings of rural neighbors.
“Imagine you’re about 18 years old and you want reproductive care and you’re in rural Montana and everyone in that county health clinic knows you, your grandparents, your brothers, sisters and uncles, your religious affiliation and everything else about you and has judgments about you,” Marum said. “And yet you’re asking for the pill. I mean, there’s something beautiful about the anonymity of being able to go into a Planned Parenthood where all you have to do is get in the door and you're safe. That’s how I felt when I was 18.”
Plaster countered that there are states where Planned Parenthood has closed shop and that hasn’t been the end of the world for women.
“It’s worth noting that in North Dakota, there’s no Planned Parenthood at all,” Plaster said. “There are 71 health centers.”
There are North Dakota clinics that provide abortions.