(This article originally appeared in the January/February 2016 issue of Focus on the Family Citizen™ magazine.)
When the annual contract for Planned Parenthood of Northern New England (PPNNE) came up for a vote before the New Hampshire Executive Council on June 22, 2011, Dan St. Hilaire knew what was expected of him: To rubberstamp funding approval for the organization’s six centers around the state without a second thought, this time to the tune of $1.8 million. It had been done before, usually without controversy.
And it looked like that might happen again. Two of the five members of the council, which is tasked with appropriating funding approved by the state legislature, favored the contract renewal; two were against it.
St. Hilaire, a pro-life lawyer from Concord elected to the council that January, had the deciding vote.
When he cast it, he made history: The Executive Council, for the first time ever, denied PPNNE any funding from state coffers
"I’ve been pro-life forever … it’s a matter of conscience," he told local reporters. "You can’t separate certain things from who you are as a person. I’ve been taught to be charitable, to help people out and to be pro-life."
That decision set the wheels in motion for a years-long battle that is still continuing. At its heart: the transparency, financial integrity and safety of an organization that claims to be a valuable member of the health care community but whose critics say otherwise.
A Sneaky History
Planned Parenthood opened its first New Hampshire facility in 1966—operating one day a month in the town of Lebanon and going by the name Planned Parenthood Association of the Upper Valley. Nine years after Roe v. Wade legalized abortion nationwide in 1973, the Upper Valley chapter merged with Planned Parenthood of Vermont to become PPNNE. Today, the organization reaches New Hampshire’s 1.3 million residents through six facilities statewide.According to PPNNE’s website, the facility in Keene distributes RU-486, or the "abortion pill," up to 10 weeks after a woman’s last menstrual cycle. The facility in Manchester—operating since 2002, and also New Hampshire’s largest abortion facility—offers surgical abortions through the sixteenth week of pregnancy. The remaining facilities, meanwhile, offer a variety of "reproductive services," including birth control, tests for sexually transmitted diseases, "LGBT services" (described on the website as "education, resources and services referral") and refer women for abortions to the other facilities.
For decades, PPNNE has received approximately one-third of its funding from New Hampshire taxpayers, with federal funds making up the remainder. Over the last five years, PPNNE has received roughly $32 million from the two sources; funding doubled from $4 million in 2010 to $8 million in 2014, according to the organization’s annual financial audits.
So when the Executive Council denied that normal funding in 2011, PPNNE immediately went on the offensive.
"We can't even provide patients with antibiotics for urinary tract infections or STDs anymore," spokeswoman Jennifer Frizzell told The Huffington Post.
Yet it was PPNNE’s fiscal abundance that made St. Hilaire question the contract in the first place.
"(He) raised questions," says Michael Tierney, an attorney in Manchester affiliated with the Alliance Defending Freedom (ADF). "He saw the CEO of Planned Parenthood of Northern New England was making more than $250,000 a year. He was concerned it might not be fiscally appropriate."
St. Hilaire also noted that PPNNE’s headquarters are located in Williston, Vt. Why should New Hampshire be giving money to an organization that not only provides abortions, he asked the council, but isn’t entirely focused on local families and whose CEO makes more than a quarter million dollars every year?
When St. Hilaire asked for proof that state funds would be spent in a "fiscally prudent manner," he was "basically told, ‘This is Planned Parenthood. You can’t ask questions; just approve the contract,’ " Tierney says.
But the Executive Council didn’t. That’s when the feds stepped in: After PPNNE lost out on the money from New Hampshire, it inked a deal with the U.S. Department of Health and Human Services (HHS) stepped for $1.1 million. The deal was brokered by U.S. Sen. Jeanne Shaheen.
The behind-the-back tactic surprised the Council—but not Ellen Kolb, a longtime political activist and blogger.
"Planned Parenthood really plays up the phrase ‘trusted women’s provider,’" she tells Citizen. "If they say, ‘But we’re a trusted health provider!’ and threaten to withhold health care because the Council denies them a contract, they get support and attention."
How could PPNNE flout the Executive Council so flagrantly? Tierney and New Hampshire Right to Life (NHRTL) decided to go to the courts to find out.
On Oct. 7, 2011, Tierney filed the first of approximately 35 Freedom of Information Act (FOIA) requests seeking information on the deal from both the state and feds about why the grant wasn’t put out for competitive bidding, which would have allowed hospitals and community health centers to apply for it as well as PPNNE.
That first request produced exactly zero explanatory documents. So ADF and NHRTL filed a lawsuit in December 2011, which, after a series of court orders, finally yielded several documents from the state and PPNNE.
Yet the more communications they received, "the more questions were raised," Tierney says.
"One set of documents we got was between feds and the state. They discussed the fact that because Planned Parenthood doesn’t have state funding, they couldn’t operate under the exception to pharmaceutical law that allows for state grantees to distribute prescription drugs that normally only a licensed person can distribute."
The Manchester clinic, for example, has registered nurses on staff who, when under contract with the state, can distribute RU-486 without referring women to licensed pharmacists to have their prescriptions filled. Without state funding, however, the loophole closes.
And that meant PPNNE was now breaking the law.
That discovery led to another document, this one showing PPNNE was charging the federal family-planning grant program for marked-up retail prices on birth control pills—and both the state and HHS knew about it.
"The purpose of (distributing birth control through Title X), of keeping it all ‘in-house,’ is to cut down on costs, to be fiscally prudent for the taxpayer," Tierney explains. "Yet the difference in price was about 400 percent. The identical drugs were a quarter of the cost at Walmart, and they were being paid for by the taxpayer."
Kolb, who has attended every open hearing related to New Hampshire right-to-life issues for the past 20 years, says this wasn’t the first time PPNNE had displayed disdain for open government.
"The leadership at Planned Parenthood likewise has a great deal of contempt for Americans who are not invested in their services," she says. "Planned Parenthood takes care of its own."
PPNNE circled the wagons even more closely in 2012, after ADF requested information on its internal operations and pharmaceutical distribution practices. Tierney and his team also requested a medical manual from the federal government explaining how it operates its Title X clinics, because that manual is nearly the same as the one Planned Parenthood affiliates rely on nationwide. ADF wanted to compare the pill distribution policies from health care centers that don’t perform abortions with PPNNE’s practices.
A federal district judge ordered state officials to release parts of the manual, but they refused. By this time, more than a year had gone by, during which PPNNE should have renewed another annual contract. Eventually, after more FOIA requests, ADF had to re-litigate to receive any of the information it requested.
"(PPNNE) likes to keep the situation in the dark," says Bryan McCormack, executive director of Cornerstone Action, a state public policy group associated with Focus on the Family. "You don’t really know how many abortions are being performed, what they’re up to, whether or not they are performing horrific practices like (selling fetal body parts)—and we don’t have a way to find out."
In 2011, the ADF team had filed Buzzell v. New Hampshire Board of Pharmacy, a lawsuit alleging PPNNE administrators were improperly allowing the distribution of RU-486 pills past their safe "use-by" date, as well as turning a blind eye to facilities that encouraged women to take the pills at home instead of under the eye of a trained physician, as the FDA stipulates. The New Hampshire Supreme Court dismissed the suit in October 2014, resulting in a victory for PPNNE.
"The power level is based on getting whatever (PPNNE) wants, and overruling what municipal leaders want," McCormack says.
A Defunded Future
Two things PPNNE wants desperately are more funding from taxpayers and more political victories. According to its financial records, the group’s profit has been increasing by an average of approximately 4 percent annually since 2010. PPNNE, in turn, has steadily increased its spending on public policy lobbying.
"While previously they had been spending $700,000 testifying in front of state legislatures, direct mailing and (support) shirts," Tierney says, "in recent years, (PPNNE) has doubled that to $1.5 million, and spent another $1 million on fundraising. This is $2.5 million out of $20 million—the entire budget for the year."
Once again, if the Executive Council has its way, that money will not include funding from taxpayers in the future: Last August, New Hampshire became the second state to defund Planned Parenthood in the wake of a series of undercover videos showing executives appearing to barter the sale of fetal tissue from aborted children. The deciding vote was cast by Councilor Chris Sununu—a Republican who had voted to fund PPNNE in the controversial 2011 decision.
"New Hampshire would not even be considering approving such a contract if it were not for the political influence that Planned Parenthood has," Sununu wrote in an editorial published in the Hampton-North Hampton Patch in August. "There is precedent for rejecting state contracts when the applicant has been under investigation and surrounded by controversy, and given the sensitivity and seriousness of this issue, Planned Parenthood should be held to a similar standard of scrutiny."
That’s scrutiny PPNNE scurries from as it dodges continual legal efforts to procure key documents. One of the most recent wrinkles: Last September, the state blamed PPNNE for the delay in producing the information courts ordered it to hand over in 2012. The state allegedly needed to get PPNNE’s permission first, which wasn’t granted. That case is ongoing.
In the meantime, Tierney is waiting on four crucial documents, one of which details why PPNNE feels it deserves "four times the cost of a birth control pill purchased at Walmart," and will hear from the New Hampshire Supreme Court around June concerning that document’s impending arrival.
Pro-life advocates suffered a major setback on Nov. 16, however: That’s when the U.S. Supreme Court declined to hear the New Hampshire Right to Life v. Department of Health and Human Services, concerning whether HHS can withhold documents and information about the "secret" 2011 grant.
HHS claims it can’t release the documents because the information they contain would affect PPNNE’s "competitive position" when facing a possible commercial grant competitor in the future, and refused to shed any light on how it arrived at the decision to fund PPNNE directly.
"We had hoped the U.S. Supreme Court would consider this case, which would have addressed whether the government can continue to veil its support for Planned Parenthood," Tierney said. "HHS is withholding documents that are critical in evaluating apparently illegal funding that the administration provided to the abortion giant despite New Hampshire’s grave concerns and without following normal protocols."
Still, pro-life advocates in New Hampshire say the fight to unmask PPNNE isn’t over.
"The defunding, the lawsuits on RU-486, the number of places where you are seeing suspicious behavior—if it’s actually acted upon, it has potential to change how things happen on the ground politically," says McCormack. "Planned Parenthood has a full-time paid lobbyist here, great media connectivity, and on top of that, their campaign operations are stellar.
"If that all goes away, you really open the door for major change in New Hampshire."
FOR MORE INFORMATION
Find out more about New Hampshire Cornerstone at nhcornerstone.org/; the Alliance Defending Freedom’s website is telladf.org. Learn about New Hampshire Right to Life at nhrtl.org. Read Ellen Kolb’s insights on New Hampshire’s pro-life activities at leavenfortheloaf.com.