Hope Broussard, 20, sought care at a Planned Parenthood in Washington in 2023 when her IUD became lodged in her cervix and the clinics in her hometown of Sandpoint, Idaho, weren’t able to help. She now lives in Pullman, Washington. (Photo by Geoff Crimmins for States Newsroom)
Fifth in a five-part series.
Hope Broussard’s intrauterine device should have brought relief from her severe periods. But at 17, it started causing debilitating pain.
At the Sandpoint, Idaho, clinic where the device was implanted, providers suspected it was embedded in her uterine wall, but lacked the ultrasound equipment to make a diagnosis.
Homeless with no insurance after her mother kicked her out, Broussard couldn’t enroll in Medicaid as a minor without a parent’s involvement. The women’s clinics in Sandpoint couldn’t help. Hospital bills were out of the question.
“The only people that were able to help me were Planned Parenthood,” Broussard said.
She sought care across the border in Washington, at the Spokane Planned Parenthood, where an ultrasound showed the IUD was coiled around her cervix. A specialist carefully removed it in a follow-up appointment and she paid $20 for everything because it was all she could afford.
“It really was my saving grace at the time,” said Broussard, who moved from Idaho to Pullman, Washington, in part because of that experience of being unable to access health care locally. “I have no idea what I would’ve done if I didn’t have that option available to me.”
Broussard is one of more than 2 million people nationwide who used Planned Parenthood for health care between 2023 and 2024, according to the national organization’s annual report. But how many people will be able to afford and access care is changing after a new federal provision prohibits some organizations that provide abortions from receiving Medicaid payments for at least a year. Nationally, Planned Parenthood estimates it could lose $700 million from Title X and Medicaid cuts, forcing affiliates to close some clinics, curtail services and stop accepting Medicaid patients.
Many Republican lawmakers and anti-abortion groups celebrated the provision passed by Congress in July that essentially targeted Planned Parenthood clinics nationwide for “defunding” because abortion care is part of clinical services in many states where access is mostly legal. Federal Medicaid dollars cannot be used to pay for abortions except in limited circumstances, and abortion care makes up a small percentage of overall care provided by clinics. Still, conservatives argue the mere association with any such clinics is equivalent to funding all abortion.
“Planned Parenthood’s desperate ploy for our tax dollars only underscores why the One Big Beautiful Bill is such a historic win,” said Susan B. Anthony Pro-Life America President Marjorie Dannenfelser in a July statement. “It halted, for the first time, over half a billion taxpayer dollars from propping up the corrupt abortion industry.”
Democratic-led states are in troubleshooting mode
In response, elected officials in some Democratic-led states, including Washington, Hawaii, Colorado and Massachusetts have publicly pledged to backfill the funding needed to allow Planned Parenthood clinics to keep accepting Medicaid and other low-income patients. In July, Washington Gov. Bob Ferguson committed to filling the $11 million gap Planned Parenthood expected to see.
Many states don’t begin their legislative sessions until January, so some of the plans aren’t official yet and still need to make it through the legislative process or the details of allocation are still in progress. That means clinics either have to absorb the costs for now with the promise of reimbursement, or change their payment options and services for the time being. For example Hawaii is moving to sliding-scale fees for some Medicaid patients, and in Maine, a major independent clinic is making changes to its services.
Idaho’s border with Washington and Oregon is a point of contention among lawmakers across state lines, where the political views could hardly be more polarized between the hard-line conservatives in Idaho and progressive politics in the other two states. But for the people who need abortion care, or even a basic ultrasound, like Broussard, clinics in places like Spokane and Ontario, Oregon, are some of the last options available.
Oregon lawmakers are also brainstorming ways that the state can provide reimbursement to Planned Parenthood for lost funding. Clinics across the state billed Medicaid nearly $17 million for services in 2024, according to the Oregon Capital Chronicle.
Courtney Normand, the Washington state director for Planned Parenthood Alliance Advocates, said this latest move from Congress is adding to challenges from the first Trump administration when there were other cuts, along with health care system pressures from the COVID-19 pandemic, and the impact of increasing patient volumes after the U.S. Supreme Court’s Dobbs decision that upended federal abortion rights protections.
“It feels like the hits have just kept on coming in Washington, and that’s why access, affordability and stable funding is our key concern,” Normand said.
Brita Lund, the health center manager at a Planned Parenthood in Seattle, worries about having to turn away patients if the federal Medicaid cuts and other strains on the health care system become too much to bear. She already feels like she spends too much time grilling a patient about their personal details at an appointment so the staff can find a way to get the treatment paid for by a specific pocket of funding.
“Who is going to help these people if we’re not going to help them? I want someone to give me that answer,” Lund said. “It literally keeps me up at night.”
While Washington state is known for being one of the most openly accessible for sexual and reproductive health, a budget crisis led legislators to cut 55% of the funding to the Abortion Access Project, about $8.5 million. Normand said it’s hard to know exactly why legislators made the decision, but some regretted it and are trying to find a solution for the upcoming session. Ferguson pledged to restore the funding as well.
‘I know the state is supportive, it’s just about what their capacity is’
In Hawaii, Title X cuts from the Trump administration earlier this year amounted to about $2.1 million, said Jen Wilbur, Hawaii state director for Planned Parenthood Alliance Advocates. The state legislature acted quickly in April to approve a new $6 million family planning fund to offset that loss over the next two years, with $3 million specifically allocated to Planned Parenthood clinics. What the funding program will look like exactly is still to be determined, Wilbur said. The needs vary by island, and an assessment of what those needs are is underway.
Hawaii has trended slightly more conservative than other blue states in recent elections, Wilbur said, but support from lawmakers still feels strong. She and other advocates are trying to game plan in the event that the federal government restricts access to mifepristone through the mail, which would severely affect access for the islands.
But Wilbur worries about the long-term sustainability of the funding in a small state that already has many challenges with high cost of living, difficulty retaining providers and navigating the unknown.
“We don’t even know how many more cuts are coming, so is any state really going to be able to sustain this going forward? I don’t know,” Wilbur said. “I know the state is supportive, it’s just about what their capacity is.”
Short-term state fixes in Maine, Massachusetts
New England, considered a hub for abortion access and low-cost reproductive health services, has been especially impacted by the federal Medicaid rule. It affects not only Planned Parenthood affiliates, but also two nonprofit health networks that offer wide-ranging health services primarily to Medicaid patients: Health Imperatives in Massachusetts and Maine Family Planning, which, like Planned Parenthood, has sued over the new policy.
Maine’s legislature this summer appropriated about $6 million for family planning funding, to go to organizations like Planned Parenthood of Northern New England and Maine Family Planning, the largest reproductive health provider in the state with 18 clinics compared to Planned Parenthood’s four. But as Maine Morning Star reports, the temporary relief does not fully meet both organizations’ deficits, and Maine Family Planning this week announced it will end primary care services in Ellsworth, Houlton and Presque Isle at the end of October.
Still, both Maine Family Planning and Planned Parenthood of Northern New England say they will continue to see Medicaid patients free of charge for reproductive health and family planning services.
Massachusetts Democratic Gov. Maura Healey also announced the state would deliver $2 million to Planned Parenthood League of Massachusetts, which is one of the co-plaintiffs in Planned Parenthood’s lawsuit against the federal government.
“We want the people of Massachusetts to know that if you need reproductive health care services, you should continue to seek this care,” Healey said in a news release.
Massachusetts has been a leader in policy promoting access to reproductive health including abortions, which is legal in the state up to 24 weeks of pregnancy with exceptions for significant fetal abnormalities and the pregnant person’s health.
But access to broad reproductive health care even in a city like Boston remains limited, especially for people living in poverty, said Dominique Lee, president and CEO of Planned Parenthood League of Massachusetts.
Lee told States Newsroom that making a primary care or OB-GYN appointment in the Boston area can mean having to wait 60 days, while Planned Parenthoods typically have same-day appointments. She noted that the communities with the least access to low-cost reproductive health services are concentrated in central and western Massachusetts, where Planned Parenthood has three clinics.
Lee said she is grateful for the $2 million in state funding, which she calls “short-term relief.” Because Medicaid funding represented about a quarter of her organization’s revenue, Lee said it is like a business losing its biggest customer. Her goal now is to figure out how the affiliate can sustain long term. She said they are brainstorming other revenue streams like offering vasectomies.
“We have gotten really good at contingency planning,” Lee said. “But it would be great to have a business model that is sustainable, that can withstand all of these attacks, and not have to worry about it. That would be a dream.”
The affiliate’s website notes that patients can no longer use their MassHealth or Medicaid Managed plans for care at Planned Parenthood clinics but says they are still seeing “all patients.”
Health Imperatives, which operates seven clinics in southern Massachusetts, is also looking at operations.
Health Imperatives CEO Julia Kehoe said the $19 million nonprofit serves about 23,000 people annually and offers social and psychiatric services to vulnerable populations. About 40% of what Health Imperatives does is offer low-cost sexual and reproductive health services for about 10,000 patients annually, Kehoe said. For now, they are continuing to see the same amount of patients and are working with the state government for funding help.
But she said the organization is also looking at private funding because they are determined to continue seeing Massachusetts’ poorest residents, many of whom experience food insecurity in places like Nantucket, which is one of the nation’s wealthiest towns but where the main safety net for those who are not wealthy is a single Health Imperatives clinic.
“I would never, ever make the decision to not see Medicaid patients,” Kehoe said. “We exist to provide services to people who fall through the cracks of mainstream systems of care. So we’re going to prioritize people who are on Medicaid or people who don’t have insurance. What I would do is, rather than further health disparities and wealth disparities in one of the most expensive states in the country, I would have fewer clinics.”
Correction: This article has been corrected to reflect that elected officials in Maine have not yet pledged to support family planning clinics with backfilled funding. The state passed a bill last session that provided family planning funding that was already needed before the congressional bill cut Medicaid funding.
This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Missouri Independent, and is supported by grants and a coalition of donors as a 501c(3) public charity.
This post was originally authored and published by Kelcie Moseley-Morris, Sofia Resnick from Missouri Independent via RSS Feed. Join today to get your news feed on Nationwide Report®.
