Planned Parenthood of Southern New England said they need ‘sustainable solutions’ to close deficit

CT Insider – Thursday, January 30, 2025
By Cris Villalonga-Vivoni

Planned Parenthood of Southern New England, the largest provider of reproductive health care in the state, has been operating on a financial deficit to keep its locations open and accessible to patients while trying to meet the high demand for care over the last two years, said Amanda Skinner, president and CEO.

As President Donald J. Trump’s administration and Congress look to potentially cut federal funding for Planned Parenthood, including a recent freeze in all federal spending as of Tuesday, Skinner said state legislators should take action to support the health network by finding sustainable long-term solutions. One of those could be raising the historically low Medicaid reimbursement in response to the annual rising cost of health care and staff costs.

“We need to be compensated fairly and equitably for the vital healthcare services we provide,” Skinner said. “This really is a matter of health equity for our patients and for the people who count on us. An increase to our Medicaid rates would be hugely impactful to our long-term sustainability.”

Funding for Planned Parenthood comes through several streams, including fundraising, donations, direct reimbursement for services through commercial insurance, Medicaid or self-paying patients.

Medicaid is the most common type of health insurance held by patients seeking abortion care across the nation, according to the Guttmacher Institute, an national reproductive health research and policy organization. However, there’s a provision called the Hyde Amendment which prevents the use of federal funds for abortions except in the case of rape, incest or endangerment to the pregnant person’s life.

States are still able to allocate their own funds to cover the full cost of care through Medicaid beyond the Hyde limitations, but the reimbursement rates have been historically low and vary widely. An analysis by the Kaiser Family Foundation, a national health policy research nonprofit, found that Connecticut is one of 17 using state funds to cover abortions through Medicaid.

Medicaid is the single largest payer source at Planned Parenthood, making up around 40% of the patients they see in Connecticut, Skinner said. An estimated 25% of patients are uninsured and pay out-of-pocket or cannot pay at all.

Skinner said that, as a safety-net health care provider, Planned Parenthood centers do not turn away any person who comes to them seeking care, regardless of their ability to pay, and are often the only primary care providers their patients see. Most of their patients — around 82% — live at or below the 250% federal poverty level, which is $37,650 in annual salary for a single person in 2024.

Although the state does cover abortion reimbursement rates through Medicaid, Skinner said the its stayed the same since 2008 — almost 17 years ago — and only covers 51% of the cost of delivering care. She said the family planning services and abortion care providers did receive a minor adjustment, but it doesn’t come close to covering the rising cost of care and staff.

She said many leaders in Connecticut are supportive of Planned Parenthood and have consistently recognized the need to raise Medicaid reimbursement rates across the board. Back in February 2024, some lawmakers advocated to increase Medicaid payment rates for abortions by $3 million a year in the state’s budget, however, the adjustment wasn’t approved by the General Assembly.

“That’s just not sustainable when that’s 40% of your payer base, and especially when the next largest payer that you have are patients who are uninsured and often struggle to pay for their care,” she said.

This legislative season, state Rep. Jillian Gilchrest, D-West Hartford, co-chair of the Reproductive Rights Caucus and the Human Services Committee, said lawmakers are looking to increase Medicaid reimbursement rates across the board and ensure providers are fairly compensated for services.

When it comes to the abortion reimbursement rates, Gilchrest said adjustments will be needed especially since she anticipates the Trump administration will cut federal spending as he did in his first term. Gilchrest said there’s a lot of momentum and support across the General Assembly to increase the reimbursement rates this year and is optimistic that legislators will be able to approve the adjustments.

“The services that Planned Parenthood provides, family planning, HIV/AIDS, testing, breast exams — they do all these services and they do them at a reduced cost,” Gilchrest said. “Many of our residents have come to depend on, and so it is vitally important that we protect these services as we know that they are going to be under attack from the Trump administration.”

Skinner said Planned Parenthood also receives public grants to fund specific health care services, like Title X, a federally funded family planning program. She said they’ve participated in the federal program since its inception until the first Trump administration enforced a domestic gag rule that prohibited health care providers who received funding from offering abortion referrals or care. She said this effectively forced them and other providers out of the program.

The gag rule was rescinded under former President Joe Biden in 2021, but hundreds of clinics had already left the program, and the number of patients served dropped by 2.4 million nationwide, according to the Guttmacher Institute.

However, with the Trump administration back in power, Skinner said those federal grants would most likely go away again, as several in Congress have suggested cuts. She said this could result in around $1.89 million in lost funding just from Title X alone.

She said there are also concerns about the Trump administration finding ways to stop Planned Parenthood providers from participating in the Medicaid program, which would be devastating for their already vulnerable patients.

Project 2025, a multi-pronged initiative to promote conservative policies under a Republican presidency, also includes several provisions that aim to limit abortion care, including threats to medication abortion, denying access to care in emergencies, reinstating the domestic gag rule on Title X, and more.

On Tuesday, a memo from the White House budget office called for a freeze on all federal assistance spending, spreading fear and confusion among local nonprofits, cities and towns, only to have it temporarily halted by a federal judge and eventually rescinded by the Trump administration on Wednesday. On Tuesday Planned Parenthood of Southern New England said it didn’t have access to the funding it directly receives from federal agencies, including Title X.

Given the past few tumultuous days, the financial future is uncertain. Skinner said that if they do not address it through higher Medicaid reimbursements and other long-term solutions, the deficit will only continue to grow as costs increase. This ultimately impacts the access to care for their patients across the state and will add a burden to the statewide health care system struggling to keep up with demand.

“When we talk about the problems that we face … what we’re really talking about is the end impact on the patients and communities who are counting on us,” Skinner said. “We say that we provide care no matter what and that we won’t turn people away that is so deeply ingrained in our mission and who we are as an organization. We’re only able to live up to that promise if we are adequately supported in doing so.”

Access this article at its original source.