Late last Friday afternoon, a time when news releases come with weekend cover, Lt. Gov. Ron Ramsey sent an uncharacteristically effusive bulletin praising his onetime nemesis and chocolate-pie lover, Gov. Bill Haslam, for "administratively" defunding Planned Parenthood. The Tea Party Republican slathered it on, hailing the governor who finally "turn[ed] off the spigot of taxpayer funds" to the family planning organization, which provides services to low-income women and families in Nashville, Memphis and Knoxville.
"I was proud to lead the charge to turn over family planning services to the county health departments, effectively defunding the organization in 93 out of 95 counties," Ramsey said of an ongoing legislative effort — akin to what 10 other states and congressional Republicans have tried this year (and failed, except for Indiana) — to purge the state of Planned Parenthood.
As if to underscore the uncomfortable ambition of Ramsey's affection, the 93 counties about which the lieutenant governor crows never actually contracted with Planned Parenthood in the first place. In fact, the whole of the $1.1 million in federal money disbursed by the state to county governments for additional family planning services has always gone to Shelby* and Davidson counties, where it was passed along to Planned Parenthood to provide preventive care and testing for Tennesseans of more modest means than any Haslam or Ramsey.
Nashville's share is about $335,000. The Metro Health Department, which also receives about $500,000 a year to provide its own family planning services, will take over the entire operation on July 1.
Planned Parenthood has always been a sort of salve for Tennessee's biggest (and cash-strapped) counties, where the need for services outstrips local resources. Now, Metro health officials worry about the quick turnaround to support what could be a deluge of new patients, who will face higher prices for birth control, general preventive care and testing at Planned Parenthood. The health department has no additional staff, space or resources with which to expand services for its client base, which could almost double in the worst case.
"When we run the numbers, it really is not going to pay for everything involved," says Chris Taylor, director of community health at the Metro Health Department. "There's probably going to be some in-kind cost in local dollars that will have to go to support this, and we don't have any expectation that we'll get additional funding from Metro government because they're hurting as well."
After years of attacks from conservative state lawmakers, though, officials with Planned Parenthood of Middle and East Tennessee (which also serves Knoxville) have prepared. Jeff Teague, president and CEO, says the board of directors voted this year to decline the federal money, which comes via the Title X Family Planning Program, a Nixon-era law that is intended to provide contraceptive services and information to anyone who needs them — with a priority given to the poor.
"We're going to make sure that we're continuing to provide all the services we have to as many clients as possible," he says. "This means that we are going to have to ask our clients to pay more for their care than what they have been paying, and we understand that there will be some of our clients who aren't going to be able to pay more."
Taylor says the health department now sees about 4,000 patients a year over some 9,000 visits. Meanwhile, since 2008, Nashville's Planned Parenthood office has seen a 20 percent increase in its client load.
"In every situation where Planned Parenthood as a health care provider is losing its funding because a state or a county is making an ideological decision to stop funding them, the people who suffer are going to be the patients in that community," says Jordan Goldberg, state advocacy counsel for the national Center for Reproductive Rights.
For low-income Nashvillians who decide to stick with Planned Parenthood, their costs for services will rise. For the Metro Health Department, a little more money comes with a lot more responsibility — a level to which officials there aren't yet sure they can rise. And for Ramsey, Haslam and the others for whom conformity to a bizarre obsession outweighs actual public service, they are free to luxuriate in something only they are capable of perverting into a victory.
*As of press time, Shelby County officials were still considering whether to turn off their "spigot."
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