As Executive Council meets, affordable reproductive health care hangs in the balance

By: - September 15, 2021 5:50 am
A sign outside of a health center that says "Civility, compassion, love"

State funding cuts may force the Equality Health Center in Concord to cease services or offer fewer patients sliding-scale fees. (Annmarie Timmins | New Hampshire Bulletin)

When a package arrives at the Equality Health Center in Concord, Executive Director Dalia Vidunas opens it outside and away from staff, in case it explodes. Alerts arrive almost daily from other clinics under attack. Protesters tell patients, whether they arrive for cancer screenings or abortions, they are murderers. 

Providing reproductive health care has become harder in recent years, Vidunas said. Advocates say it’s about to get harder still. 

Earlier this year, family planning centers, which offer birth control, STD testing and treatment, pap smears, and other routine care to about 15,000 low-income Granite Staters annually, saw their funding drop in the state budget. And, on Wednesday, the Executive Council will consider contracts with those centers that, if rejected, will lead to a drastic reduction in affordable reproductive services, advocates say. 

At issue are the few providers that provide abortions in addition to the other reproductive care, even though they’ve complied with a new state law requiring proof they use only private – not state – money for abortion care. They include Planned Parenthood of Northern New England, which has clinics around the state, Lovering Health Center on the Seacoast, and Equality Health Center in Concord.

“A tremendous amount is at stake for our patients,” said Vidunas, who said state funding cuts may force the center to cease services or offer fewer patients sliding-scale fees. The center barely breaks even on STD testing, for example. “I feel like the safety net for people who have lower incomes and are uninsured or underinsured is being taken away from them.”

Sandi Denoncour, executive director at the Lovering Health Center, said she’s already lost about 50 percent of funding as a result of budget cuts, enough that the center will have to scale back services if its contract does not pass. Denoncour said threats to family planning funding and the new 24-week abortion ban have felt like extreme shifts that don’t match public sentiment.

“I feel this is not an accurate reflection of the New Hampshire voters’ opinion on these matters,” she said. “I feel New Hampshire voters strongly support reproductive health care and choice in our state. This feels like a departure from where our citizens’ opinions truly lie.”

As of Tuesday, Democrat Cinde Warmington was the lone executive councilor to say publicly she will support the contracts. The other four councilors, all Republicans, have either voted against funding for some of those providers or said they would favor contracting only with agencies that do not offer abortions, regardless of what funding they use. 

Three of the four – Councilors Joe Kenney, Janet Stevens, and David Wheeler – did not return messages this week. Councilor Ted Gatsas said he had not looked at the agenda, contracts, or emails from concerned constituents. He declined to say how he will vote.

Gov. Chris Sununu, who sets the meeting agenda but does not have a vote, said he supports the contracts. “As I have done every year as governor, I am bringing forward these family planning contracts and would urge all executive councilors to approve them to ensure continued access to these critical services,” he said in a statement.

Pro-choice advocates have been sounding the alarm for weeks in anticipation of a council vote. That includes Congressman Chris Pappas, who joined leaders from Planned Parenthood of Northern New England and the Women’s Foundation for a recent Zoom roundtable. 

“The Family Planning Program is not about abortion, it is about critical health services,” said Pappas, who voted for the family planning contracts during his tenure on the Executive Council. “State and federal support for those are very critical. Annual exams, cancer screenings, wellness checks, and contraception, these are the kinds of things that are going to keep people safe and keep people healthy. Tying this all into a political attack on abortion rights, it really serves no purpose other than to make a political point.”

Republican lawmakers sought a number of abortion-related changes during this year’s legislative session. 

In addition to the 24-week ban, which also requires an ultrasound for abortions at any stage, they proposed denying state funding to family planning centers that provide abortions unless those centers physically and financially separated abortion services from their other care.

Providers, already required by law to financially separate the two, said a physical separation would be so financially burdensome it would risk their ability to provide other low-cost reproductive care. Sen. Jeb Bradley, a Wolfeboro Republican, engineered a compromise that requires the state to confirm annually that providers are not commingling finances.

The state Department of Health and Human Services had to complete those audits, a process Vidunas said consumed staff for a full week, before bringing the pending family planning contracts to the Executive Council. 

Additionally, Republican lawmakers declined to include $1.2 million in stopgap funding for federal Title X money lost under a Trump administration rule that prohibited recipients from not only performing abortions but also referring them to an abortion provider. 

When that “gag rule” prompted several New Hampshire reproductive health centers to forgo the Title X money during the prior legislative session, Democrats had the votes to replace that money with state dollars. This year’s Republican-controlled Legislature declined that request, leaving providers with less funding. 

Amoskeag Health is among those waiting on the Executive Council’s vote. Amoskeag does not provide abortions as part of its family planning services, but like its peers relies on its contract to provide routine health care to low-income men and women. 

“At our Nashua site, we have a high concentration of uninsured patients, and breaking even is hard,” CEO Kris McCracken said. “So this funding helps us deliver the care.”

Lamprey Health Care, which does not provide abortions, typically receives $229,000 a year in state and federal funding, said CEO Greg White. That’s gone down considerably, he said, and raised questions about what services he can continue to staff. 

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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications.

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