This story was originally produced by the New Hampshire Bulletin, an independent local newsroom that allows NHPR and other outlets to republish its reporting.
Executive councilors have voted 4-1 to deny funding to the state’s largest providers of low-income reproductive health care three times in less than a year. On Wednesday, the Department of Health and Human Services will ask them to reconsider – again.
Democratic Councilor Cinde Warmington continued Monday to publicly support the family planning contracts. Republican Councilor Joe Kenney indicated he’s likely to continue to oppose them. The other three councilors, Republicans Janet Stevens, David Wheeler, and Ted Gatsas, did not return messages.
What is certain is the department’s next step if the contracts fail a fourth time.
“If we run into a wall every single time, we are going to continue bringing it forward and run into that wall,” said Commissioner Lori Shibinette in an interview last week. “We won’t stop.”
The $1 million in proposed contracts with Planned Parenthood of Northern New England, Lovering Health Center, and Equality Health Center would serve nearly 17,600 Granite Staters, with a focus on people who are low-income, uninsured, underinsured, adolescents, LGTBQ+, refugees, and people at risk of unintended pregnancy because of substance abuse.
The proposed money can be used for basic reproductive health care, such as cancer screenings, STD testing and treatment, birth control, annual exams, and education on abstinence and safer sex. Under the contracts, providers may answer questions about abortion and refer patients to centers that provide abortions, but they cannot use contract funding to perform abortions.
None of the providers have violated that rule, according to statements and information provided to councilors by Heath and Human Services, which is now required by the Legislature to audit providers. The Attorney General’s Office has confirmed those findings, but the assurances have not been persuasive.
Kenney reiterated his concerns Monday about misuse of public money.
“If (reproductive health care services) are all under one tent, one umbrella, I have a hard time supporting funding going to an organization that provides abortions,” he said. Kenney said he would feel differently if the organizations had created separate spaces and budgets for their abortion work and the other reproductive health care.
Republican lawmakers had sought the same operational divide during budget negotiations last year but agreed to the requirement that the providers be audited in a compromise proposed by Sen. Jeb Bradley, a Wolfeboro Republican.
Kenney said he will have additional questions for the department Wednesday about the state’s obligation under the new abortion law, which he said “allows abortions up to 25 weeks, I believe.” The law prohibits abortions after 24 weeks with two exceptions: risk to the mother’s life and a fetus that will not survive on its own after delivery.
On Friday, the Joint Legislative Fiscal Committee passed a related funding request from the department that sought to accept and spend about $1.4 million in federal money for family planning.
Questions about what the money can – and can’t – be used for led Sen. Gary Daniels, a Milford Republican, to vote against it.
The department had not yet made public that it hoped to direct some of that money to Planned Parenthood of Northern New England, Lovering Health Center, and Equality Health Center, all of which provide abortions as part of their reproductive health care using private money.
When Daniels asked Trish Tilley, director of the Division of Public Health Services at Health and Human Services, what the money could be used for, she answered that none of the money can fund abortions. The money can be used only for reproductive health care such as contraception, cancer and STD screenings, and education, Tilley said.
While the department did not ask the fiscal committee to approve particular contracts Friday, Daniels said he was upset to see the three providers identified a few hours later on the Executive Council agenda, after being told during the meeting the providers’ names were not yet public.
“‘None of the money is going to abortion services,’ means different things to different people,” Daniels said Monday. “Does that mean none of the money will be used to pay for someone who is referring for abortion? Those kinds of things weren’t answered. I think the answers that were given were very vague and pretty broad.”
The department’s request passed the fiscal committee, 9-1.
Until recently, the state’s “Family Planning Program” provided low-cost, high-quality reproductive health care to people in all parts of the state.
The council’s votes in 2021 and in January to defund Planned Parenthood of Northern New England, Lovering Health Center, and Equality Health Center did not close those centers but eliminated them from the program, leaving just four sites supported with state contacts in Berlin, Laconia, Manchester, and Nashua. The contracts before the council Wednesday would expand that network to Derry, Exeter, Keene, Concord, and Greenland.
Sandi Denoncour, executive director of the Lovering Health Center in Greenland, said the family planning contract represents 20 to 30 percent of her center’s budget. It is expected to pay for care for about 370 people between now and December 2023.
“Choice of providers contributes to the success of statewide programs like family planning,” she said in an email. “While other providers on the Seacoast CAN provide services, none are obligated to provide them to the extent required by sites under contract. Having more providers in the network ensures high-quality, robust care models that the state can reinforce to best meet the current and emerging needs of our communities statewide.”
Denoncour said the funding loss led her center to eliminate a position dedicated to outreach and education. “We have worked hard to maintain our presence at community events,” she said, “but it is a strain on an already very small staff.” Despite the loss, the sliding fee has remained, she said.
“New Hampshire taxpayers and legislators have prioritized funds for this program to meet the needs of the lowest income citizens,” Denoncour said. “And while the Executive Council is empowered to approve or deny the contracts, the result of denial is stigmatizing and removes important freedoms of choice in health care for those seeking sexual and reproductive health care services.”
The proposed contract with Planned Parenthood of Northern New England says it would provide care to nearly 16,240 people over two years. After the council rejected the provider’s contract for the third time in January,it received $500,000 in federal money at the request of the federal delegation to cover some of that loss. Kayla Montgomery, vice president for public affairs at Planned Parenthood of Northern New England, said in a statement Monday that access to affordable health care remains critical and fragile.
“The fact is, with Roe v. Wade being overturned, the reproductive health care landscape in this country is (in) chaos,” she said. “Ensuring access to critical preventative health care – including birth control, cancer screenings, and STI testing and treatment – for our most vulnerable populations has never been more important. For over a year, access to affordable, quality family planning care has been in jeopardy for thousands of Granite Staters because of three consecutive votes to defund reproductive health providers.”
Warmington echoed that urgency Monday in an email.
“I have been holding this Governor and Executive Council accountable for defunding health care services … since they first rejected family planning funds last summer,” she said. “It is my hope that these councilors finally understand the impact their rejection has had on the thousands of Granite Staters in their districts seeking care, and I hope they will join me on Wednesday in supporting these vital services.”
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