COLUMBIA — The use of state money to promote alternatives to abortion is back in play in the Missouri legislature with a bill that would ban funding for "pregnancy-related services," unless the services provide medically accurate information to patients.
The main targets of House Bill 236 are crisis pregnancy centers, which purport to be clinics where pregnant women can fully explore their options. But Rep. Deb Lavender, D-Kirkwood, the sponsor of the bill, said that centers often don’t explain to women that they don’t provide abortions.
Lavender said she was inspired to introduce the bill after people in St. Louis protested crisis pregnancy centers in the wake of a story by the political blog ThinkProgress about the centers' state funding. ThinkProgress used research by the women’s reproductive rights organization NARAL that found crisis pregnancy centers frequently provide false or misleading information to women.
A majority of studies are by partisan organizations, but a 2006 report by the Special Investigations Division of the House Committee on Government Reform analyzed 25 centers that received federal funding. Investigators posed as 17-year-olds deciding whether to get an abortion. Of the 25 centers, 23 were successfully contacted, and 20 of those provided false or misleading information.
Eight centers told investigators that an abortion would increase the patient’s risk of breast cancer, despite a medical consensus that it is not true. Seven centers told investigators that abortions cause an increased risk of infertility. Thirteen centers said having an abortion causes severe psychological effects.
Of more than 60 crisis pregnancy centers in Missouri, none provide abortions. Crisis pregnancy centers that receive government funding or participate in a government tax credit program where donors are incentivized by receiving tax credits are not allowed to provide abortions or refer women to an abortion clinic. The only abortion provider in Missouri is the Planned Parenthood of the St. Louis Region and Southwest Missouri in St. Louis.
"If they don’t want to provide abortions, I’m okay with that," Lavender said. "Just don’t deceive women."
Some of the pregnancy centers are part of an Alternatives to Abortion Services Program that Missouri funds with state appropriations and a portion of a federal welfare block grant the state receives, Temporary Assistance for Needy Families.
Columbia's crisis pregnancy center, My Life Clinic, does not receive state funding. One of the nearest clinics to Columbia that does receive state funding is a clinic in Waynesville named Free Women's Center.
For fiscal year 2016, the Alternatives to Abortion Services Program received its usual state funding, approximately $2 million, according to the Office of Administration budget bill. But for the fiscal year 2017 budget, the alternatives to abortion section had an additional line of funding — from the Temporary Assistance for Needy Families grant.
TANF provides cash assistance to families with children for a limited amount of time. Programs funded by TANF must meet at least one of the grant’s four stated goals:
- Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives
- End the dependence of needy parents on government benefits by promoting job preparation, work and marriage
- Prevent and reduce the incidence of out of wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies
- Encourage the formation and maintenance of two-parent families
It’s largely left to states to decide how to use their TANF funds to meet those goals. Missouri uses its funding in a variety of ways, including cash assistance, child care programs, job training and, now, alternatives to abortion services.
Alison Dreith, the executive director for NARAL Pro-Choice Missouri, said she thinks the use of federal welfare money to fund the Alternatives to Abortion program should not be a partisan issue.
"We need to be taking care of these families instead of literally taking food out of their mouths to fund ideological agendas," she said.
The Missouri Alternatives to Abortion Services Program became law in 2007 but had been receiving state funding in earlier years. The program encourages women to carry their pregnancy to term by providing them with services during pregnancy and for up to a year after they give birth.
Services include prenatal care, adoption assistance and counseling, among others. Nine organizations are contracted to provide alternatives to abortion services, according to Ryan Burns, director of communications for the Missouri Office of Administration. Other qualified centers that are not part of the Alternatives to Abortion Services Program provide similar assistance.
Women are eligible for the Alternatives to Abortion Services Program if their incomes are at or below a certain federal poverty threshold — for fiscal year 2017, that is $21,978 per year for a one-person household — and choose to not have an abortion, according to the program’s website.
In 2015, the Senate overrode then-Gov. Jay Nixon’s veto of Senate Bill 24, which decreased the amount of time families could receive TANF cash assistance from 60 to 45 months beginning Jan. 1, 2016, with some exceptions. The goal of the change was to keep recipients of the assistance from becoming reliant on the funds and save Missourians money, according to previous Missourian reporting.
The bill, also known as the Strengthening Missouri Families Act, additionally stipulated that 2 percent of TANF funds would go toward the Alternatives to Abortion Services Program and "alternatives to abortion public awareness program."
For fiscal year 2017, $4.3 million of TANF funds were appropriated to alternatives to abortion services, in addition to the more than $2 million from the state's general revenue.
"It was pretty shady when it happened last year," Dreith said. "It never had a hearing, it was just amended onto the budget on the floor of the House. So it happened really quickly without any debate."
NARAL worked with Lavender to introduce HB 236.
Lavender said that some crisis pregnancy centers' websites give the impression that they provide abortions to convince women to make an appointment; many of the websites appear to be neutral and do not explicitly state whether they provide abortions.
"They at no point in time tell you they don’t provide abortions," Lavender said.
Marsha Middleton, the CEO of Alliance for Life, one of the organizations contracted by the Alternatives to Abortion Services Program, said all clinics under the Alliance for Life network are staffed with medical professionals.
"Under the contract requirements of the Alternatives to Abortion Program, we're required to have credentialed personnel," Middleton said. "And part of that credentialed personnel is medical and social work personnel."
Middleton also said that not all clinics under Alliance for Life opt to receive the government funding, and not all women the clinics serve are necessarily in the Alternatives to Abortion Services Program.
Twelve of the clinics under the Alliance for Life network contacted by the Missourian either did not return calls or declined to comment.
Lavender said she doesn’t expect HB 236 to get very far, given the Republican supermajority in the General Assembly, but thinks "having a conversation about lying to women" will open up an important dialogue.
Dreith said it would be a shock if the bill passed, but said she think it’s a chance to talk about Missouri’s priorities.
"Let’s stop obsessing about further restricting women’s access to abortions, which the state clearly shows it has been obsessed with, and focus on fixing our roads and bridges, sending our children to school five days a week, all of the other things Missourians focus on in their everyday lives," Dreith said.
Supervising editor is Katherine Reed.