For New York City abortion providers, Planned Parenthood proves an integral safety net
If Planned Parenthood NYC is forced to close its doors or limit services, abortion access will remain — but the availability of comprehensive reproductive care will suffer
Rachel Cunningham was 17 when she realized that seeking out healthcare could be seen as a political act.
“I felt so grown up,” said Cunningham, now 25, of the first time she visited Planned Parenthood. “I had borrowed my mom’s car, I was driving there by myself — and then I saw this guy.”
Parked across the street from the San Mateo, California location was a local man known for displaying two-foot-high posters of “aborted fetuses” on the back of his truck. Cunningham didn’t want to get out of her car.
“All I wanted was a prescription for birth control!” said Cunningham, an actor, who grew up without health insurance. Despite their tense introduction, Cunningham has remained a Planned Parenthood devotee throughout stints living in Ohio and now New York City, which has served as the nexus for women’s health care in the United States for over a century.
In 1916, the nation’s first family planning clinic opened in Brooklyn’s Brownsville neighborhood. For the week and a half that it remained open, a line of women seeking information on birth control wove its way down the block. Nine days later, its founder, Margaret Sanger, was arrested for violating an obscenity law.
Sanger’s name now graces the Manhattan location of Planned Parenthood NYC, one of five located throughout the five boroughs. The centers function in tandem with the city’s 12 additional clinics and physician’s offices that provide abortions and a limited range of other services. Dr. Robert Blatt, a physician at Eastside Gynecology, said in an email that his office regularly refers patients to Planned Parenthood clinics, largely due to scheduling issues. Eastside Gynecology is closed on Mondays, said Blatt, and for patients anxious to be seen, Planned Parenthood is a reliable alternative.
It’s a delicately balanced ecosystem, one that handles reproductive care for the more than 4.4 million women living in the greater New York City area, as well as a steady stream of patients from New York state, Connecticut and New Jersey. But what has grown over decades into a supportive web is now in danger of faltering.
Since March, the GOP has made three attempts at repealing and replacing the 2010 Affordable Care Act. Their initial solution, the American Health Care Act, took aim at Planned Parenthood. The reform bill threatened to suspend Planned Parenthood’s federal Medicaid reimbursements for one year.
In keeping with the 1976 Hyde Amendment, federal Medicaid cannot be used for abortions, except in cases of rape or if a woman’s life is in danger. New York is one of only 11 states in which state-funded Medicaid covers the majority of terminations. So in blocking federal funding, says Heather Sager, a board member for the New York Abortion Access Fund, what actually suffers are, “Services for things like well-woman visits or breast or cervical cancer screenings.”
In 2016, Planned Parenthood NYC served more than 60,000 patients and conducted more than 110,000 procedures, including 104,426 STI tests and 832 HPV vaccines. 60 percent of their clients relied on Medicaid to pay for services. Cunningham is one such case.
“I know what I’m getting,” said Cunningham of Planned Parenthood. “Convenience, respect and consistency have become really important to me.” It’s where, over the years, she’s received two of three HPV vaccinations, prescriptions for birth control and pap smears. But Cunningham says she has avoided seeing other doctors on her Medicaid plan because she’s often given wrong or inconsistent information regarding her appointment.
“I have to run around in circles,” said Cunningham, who had in fact spent the morning literally running through her Central Harlem neighborhood after being sent to the wrong office for an appointment with her GP.
And then there’s the waiting period, which she says often hovers around three months. She’s grateful for the quick, self-serve scheduling style of Planned Parenthood. So is Oluremi Olufemi, also 25.
With her mother moving often and her father out of the country, Olufemi says she’s relieved to be self-reliant when it comes to health care, receiving insurance through work. But while cost is not an issue, time certainly is. Olufemi works full-time for the New York Department of Education, nannies for a family in Brooklyn and up until her graduation in May was also attending graduate school full-time. “Name brand health care,” that’s easy to Google with flexible, online scheduling is the only way she would have received reproductive care since moving to New York from Chicago three years ago. Otherwise?
“Oh my god, I’d put it off like I do with everything else with my body,” said Olufemi over the phone, while fixing a snack for one of the children she watches several times a week. “So much happens within the 9-to-5 window, and if your job is really your livelihood, you can’t just take a day off.” Olufemi has frequented four of the five Planned Parenthood locations spread throughout the boroughs.
An administrator at the Bronx Abortion Clinic, which serves an average of 25 women a week, expects a jump in patients should Planned Parenthood locations be forced to close or limit services. So does Dr. Blatt, who already treats upwards of 5,000 patients a year. Both feel their offices could handle the impending influx of cases if necessary.
But Bronx administrator Irene, who preferred to give only her first name for fear of further harassment from protesters, emphasized that access to abortion is only one piece of the reproductive healthcare puzzle. What she worries about is the availability of services outside abortions, the access to comprehensive care that many of her patients, 80 percent of whom rely on Medicaid, need. Access that could ultimately reduce the number of women seeking abortions in the first place.
The speculation regarding Planned Parenthood NYC’s ability to provide care is purely hypothetical — for now, at least. Carrie Mumah said in an email that although Planned Parenthood NYC stands to lose $12 million a year should their federal Medicaid reimbursements be suspended, their five locations will remain open — same hours, same services. She declined to say how, logistically, that will happen or comment on the long-term sustainability of such a situation.
Dr. Blatt, for one, sees the current uncertainty as a sink-or-swim moment for New York City’s healthcare system.
“Initially, we may see a reduction in the availability of access points for women to receive care,” he said. But the hope is that the remaining offices will step up, adapt and expand, continuing in what they see as a very straightforward situation: providing imperative care for millions of reliant patients.