- Associated Press - Sunday, April 30, 2017

LINCOLN, Neb. (AP) - Nebraska clinic administrators worry an attempt to slash funding for abortion providers could force clinics throughout the state to cut services or close, leaving thousands of low-income women without access to reproductive health care.

The proposal would allow state officials to reduce or eliminate funding for the state’s two Planned Parenthood clinics that perform abortions. But it also could mean less funding for clinics that specialize in reproductive health but don’t provide abortions, according to providers who are imploring lawmakers to strip it out of the state budget.

Some Democratic members of the budget-writing Appropriations Committee said last week they didn’t realize how the wording would affect the health care providers. Gov. Pete Ricketts included the language in his proposed budget.

“If they want to try to close these centers because of their political views, then sneaking it into the budget isn’t the right place,” said Sen. Patty Pansing Brooks of Lincoln. “This is a policy decision.”

Lawmakers gave the budget preliminary approval Wednesday on the promise they will try to reach a compromise before the next vote.

At issue is budget language that would require the Nebraska Department of Health and Human Services to prioritize certain health care providers over others when awarding federal Title X money. Title X money helps cover the cost of preventative care and family planning services, such as birth control, tests for sexually transmitted infections and cervical cancer screenings. It can’t cover abortion services, but abortion providers can and do receive the money for other services.

The language would allow the department, a part of Ricketts’ administration, to deny or reduce funding for clinics that only provide reproductive health services. Supporters of the proposal say those facilities can still apply but argue funding should first go to hospitals and health care facilities that offer a wider range of services.

Abortion-rights advocates said it’s a clear effort by lawmakers to score political points.

“It is definitely a political attack on reproductive health care,” said Rachel Lopez, a Des Moines-based spokeswoman for Planned Parenthood of the Heartland, which includes Nebraska.

A December Obama administration regulation would have prevented states from withholding Title X funds from organizations that provide abortions or using a tiered approach, as the Nebraska proposal would. Congress overturned that rule in March.

One organization that would not be prioritized for funding under Nebraska’s budget is Tecumseh’s Family Health Services, which serves about 2,000 primarily low-income people in the state’s southeastern corner.

Executive Director Jean Brinkman said the organization receives about $180,000 a year - 80 percent of its budget - from Title X funds and would have to close if the funding stopped. The organization doesn’t provide abortions.

“If we close, you’re probably going to see an increase in STDs, unwanted pregnancies and HIV rates” because southeast Nebraska doesn’t have other options for affordable STD testing, treatment or contraception, Brinkman said. Many of the people who use Family Health Services don’t have the money or transportation to go elsewhere, she said.

“It’s going to be awful for the people of southeast Nebraska,” Brinkman said. “They can’t, they won’t drive to seek these services in bigger cities.”

Karen Bowling, executive director of the social conservative group Nebraska Family Alliance, said her organization supported the funding change because it would help a variety of health providers. However, an alert the alliance sent out to followers Monday said its members had the opportunity to “seize one of the most significant pro-life victories in Nebraska in years” by decreasing taxpayer funding for abortion providers.

The proposal would prioritize funding for federally qualified health centers, which the U.S. government recognizes as providing comprehensive services care including primary, preventative, dental and mental health care. The state has seven federally qualified health centers, but there are none south of Lincoln or in the vast stretch of central and western Nebraska between Grand Island and Gering. Bowling said she hoped new priorities would encourage current providers to locate in central Nebraska.

Tom Venzor, executive director of the Nebraska Catholic Conference, said nothing in the budget would necessarily prevent Planned Parenthood or other providers from receiving Title X funding. But he said the Nebraska Catholic Conference’s objection to any taxpayer money going to abortion providers does play a role in the organization’s support for the budget language.

“The main issue here is ensuring that Title X funding goes to facilities that provide the most comprehensive health care,” Venzor said.

Grand Island’s Central Health Center will have to cut back on its services if it loses Title X funding, executive director Brady Kerkman said. The reproductive health care center, which doesn’t provide abortions, receives $250,000, 20 percent of its annual budget, through Title X. It serves about 4,000 patients a year.

The center has expanded its services to provide mental health care, vaccinations and refugee health screenings. It’s also looking to add a mobile medical unit that could provide testing and medical services for people who can’t travel to the center. But other initiatives could fall by the wayside if Title X funding is dropped, Kerkman said.

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Follow Julia Shumway on Twitter at https://twitter.com/JMShumway

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