Lilo H. Stainton, NJ Spotlight

New Jersey’s network of family-planning facilities has lost $50 million in state funding over the past eight years, a reduction that is making it harder for women to get birth control, cancer screenings, and other services, according to advocates for these providers.

While the situation in the Garden State is not new, these advocates argue it is made even more precarious this year by efforts among some Republicans in Congress to limit federal payments to Planned Parenthood clinics.

Planned Parenthood leaders and providers joined Assemblywoman Valerie Vainieri Huttle (D-Bergen), on a call with reporters Thursday to share their concerns about the continued loss of $7.5 million in annual funding for family-planning services, a longstanding budget line that Gov. Chris Christie, a Republican, eliminated in 2010. Six clinics have closed since then, in Burlington, Cumberland, Hudson and Morris counties.

“We know these types of actions and funding cuts have clear consequences,” Vainieri Huttle said. “We know if these issues are left untreated they can lead to serious health issues.”

The advocates also shared findings for Planned Parenthood’s latest “Access at Risk” report, which revealed sexually transmitted disease rates continue to climb, escalating 35 percent statewide between 2009 and 2015, the most recent year for which data was available; Bergen, Gloucester, and Passaic counties saw bacterial STD rates shoot up more than 70 percent. In addition, from 2009 to 2013, breast cancer cases climbed 6.3 percent among all New Jersey women, 8.1 percent among black women, and 25.8 percent among Latinas, the report noted.

“We’ve seen the real-life impact on our patients” since the funding cuts were implemented, noted Triste Brooks, president and CEO of Planned Parenthood of Northern, Central and Southern New Jersey, which treats more than 100,000 women, men, and young people each year at 26 sites around the state.

Declining or delaying treatment

Tracey Rubin, a nurse practitioner who treats patients at Planned Parenthood facilities in Central New Jersey, said she has witnessed the changes over the past eight years as women decline or delay treatment because of cost and accessibility issues. “We’ve been seeing sicker and sicker patients because of a lack of early screening and intervention,” she said. “I see patients who have endured pain and suffering because they thought they couldn’t afford care, or get to a clinic easily.”

These barriers to healthcare, when combined with racism and classism, have left communities of color particularly at risk, added Loretta Winters, president of the Gloucester County NAACP. As a result, black women and Latinas are dying at higher rates from conditions that are less likely to kill white patients, she said.

Officials with the state Department of Health point out that STD rates have increased nationwide, not just in New Jersey, and it is impossible to know if the escalation reflects the closure of any facilities or state funding cuts. (In fact, two of the four counties that lost clinics had STD increases close to the state average.) The DOH has launched an aggressive, bilingual about STD risks and is working with local health teams in a handful of cities to increase access to testing and treatment.

And while the primary family-planning budget line disappeared in 2010 — along with federal funding that would have provided a $1 to $1 match — the proposed fiscal year 2018 budget, which starts in July, includes other funds that help address these needs, the DOH’s Donna Leusner explained. That includes $28 million for community health centers, $12 million for cancer screenings, $4.3 million for STD prevention and testing, and $2.1 million for other family-planning services.

“Hundreds of thousands of women have access to health services through Medicaid, private insurance, or state health benefits,” Leusner said. “Hospital-based clinics, community health centers, community physician practices, and public-college health centers also provide women’s health services.”

Rising STD rates

Planned Parenthood’s Casey Olesko, who helped compile the report, agreed the rising STD rates can’t be tied directly to the funding cuts. “We’re not saying there’s a causal link, but regardless, we’re seeing this increase and facts are facts.”

Plus, Olesko said the need for state support is all the more important given the uncertainty in Congress about replacing the federal Affordable Care Act, which greatly expanded coverage for birth control and access to care in general, and changes to the way Medicaid is funded. The initial plan to repeal and replace the ACA — which stalled last month as support eroded among Republicans — would have drastically changed how Medicaid is funded, likely resulting in cuts to coverage or benefits, and also included a provision specifically banning its use for any services at Planned Parenthood. (Additional amendments also threatened private insurance coverage for maternity care.)

While federal law has long prevented Medicaid dollars from being spent on abortions, it has allowed the program to be used for other services, including pap smears, breast cancer screenings, and other preventative care — services that make up the vast majority of Planned Parenthood’s work. Olesko said Medicaid covers 60 percent of Planned Parenthood patients and three out of four earn less than 150 percent of the federal poverty level, or roughly $30,240 a year for a family of three.

Few options

Patients like these have few other options for affordable, high-quality care, explained Roslyn Rogers Collins, president and CEO of Planned Parenthood of Metropolitan New Jersey. “We know there are too many who have no other place to turn,” she said. “And we know these continue to be essential healthcare services, whether they are funded (by government programs) or not.”

Family-planning services “are not optional healthcare add-ons; they are essential for health and wellbeing,” added Rubin, the nurse practitioner.

Planned Parenthood’s Brooks agreed, adding that ongoing federal discussions about ways to limit funding to the organization underscore the need for state support. “Obviously, if something happens at the federal level it’s going to make it all the more important that New Jersey does the right thing here and puts this money back.”

Democrats have tried repeatedly to reinstate the funding through supplemental appropriation bills, but Christie has refused to sign these add-ons. In October, Democratic leaders joined Planned Parenthood leaders celebrating the organization’s 100th anniversary and pledged to restore these dollars once a new governor replaces Christie, in January 2018.

For every dollar that is spent on women’s healthcare, Planned Parenthood said it saves $7 in other costs related to unintended births and other expenses. In 2010, more than half of all births were unintended and these deliveries and their associated needs added $477 million to the state’s healthcare costs, according to the new report.