Few groups had as much riding on the outcome of the 2016 election as Planned Parenthood. A Hillary Clinton win would have elevated a fearless defender of family planning and preventive health care to the Oval Office. The Trump presidency, instead, has placed Planned Parenthood in the crosshairs of a Republican-dominated government, crusading against women's reproductive freedom.
Because it serves Medicaid patients, whose care is subsidized by the government, Planned Parenthood receives significant federal funding. Republicans – in a long war, launched by incoming Vice President Mike Pence – have sought to cut off Planned Parenthood's access to federal dollars, in hopes of also crippling its ability to provide abortion services. (These are paid for privately; federal law prohibits virtually all taxpayer funding of abortion.) As a House member in 2007, Pence introduced the first bill seeking to defund Planned Parenthood. As governor of Indiana, he slashed public health funding, shuttering Planned Parenthood clinics and fueling an HIV epidemic in rural Indiana.
Beginning in 2017, the war on Planned Parenthood will be directed from the White House. Donald Trump, in a September letter to anti-abortion activists declared, "I am committed to ... defunding Planned Parenthood." With Pence leading the presidential transition, Trump has tapped as his budget director South Carolina congressman Mick Mulvaney – the Republican who led the 2015 campaign to shut down the federal government in protest of Planned Parenthood funding. (John Boehner foiled that plot, at the cost of his Speaker's gavel.)
To gauge the severity of the threat, and Planned Parenthood's strategy to defend against it, Rolling Stone recently spoke to Cecile Richards, the group's president for the past decade. In that time, she's seen triumphs, like the passage of the Affordable Care Act and the executive order mandating that insurers cover birth control, as well as bitter defeats, most recently in Texas, which moved in December to cut off state Medicaid funding for Planned Parenthood clinics. Richards, who's the daughter of famed late Texas Gov. Ann Richards – you can hear just a hint of her mother's twang as she speaks – calls the state "a cautionary tale for the rest of the nation."
As Richards laid out her plan to counter Trump/Pence, she also brought the conversation into a broader frame, making the case that activists across America will need to have each others' backs in this dark hour for American democracy. "I believe there is enormous solidarity across the country," Richards says, "not only among our supporters, but among other progressive organizations who are similarly facing unprecedented assaults."
Planned Parenthood is in the crosshairs as the Trump administration takes office. How do you understand the threat?
Let's first put this in the context of the enormous progress we've been able to make under President Obama. We're now at a record low in teenage pregnancy; 20 million-plus got health insurance through the Affordable Care Act; 55 million women now have birth control coverage because of the campaign that we led. The concern is that all of that progress it at risk now. Particularly because the incoming vice president, Mike Pence, has been a crusader against Planned Parenthood, against reproductive access, against LGBT rights. It is a serious threat.
Break down "serious" for us.
It's very serious. The fear here is about losing access to basic preventive care for millions of people. But we can win – and we will not go without a fight.
Republicans are in control of Congress. And they have voted previously to end access to care for folks who come to Planned Parenthood for basic preventive services. President Obama's veto is the reason we're still able to see millions of patients in this country. Just to be clear: This isn't about the check we get from the federal government to run our health centers. This is actually about women – primarily women, but all people who are on Medicaid – being able to come to Planned Parenthood for preventive care. It's not abortion; the federal government and Medicaid do not fund abortion services. This is literally whether a young man in Texas can come to us for an STI testing, or whether a woman who has a lump in her breast can come to us in Ohio to have a breast exam or be referred for screenings, or whether a college student or a young person anywhere in the country can come to us for family planning. We're talking about more than a million-and-a-half people who rely on Planned Parenthood, and for most of them we're their only medical provider. As all of the medical institutions have said: There's no one to take our place providing low- and moderate-income people with preventive health care. There isn't any other entity that is doing that work. In my home state of Texas, the legislature passed these outrageous bills and they closed the Women's Health Program; recently, they have reported in Texas a doubling of the maternal mortality rate. And the women it has hit hardest are low-income women of color.
You know what's coming at the federal level. What's the plan?
This is something we know a little bit about: Some of our states have been under attack for a long, long time. So they know how to fight back. We've been around 100 years and we aren't going anywhere. Come January, we will be launching the largest "Stand with Planned Parenthood" campaign in our history to agitate and engage our millions of supporters around the country to make sure we're telling the story of what people are poised to lose. We will make sure that every single senator who votes on the issue of whether patients can come to Planned Parenthood is fully aware of the millions of people who are going to lose health care, including thousands in the states they represent.
Dwell for a bit on the darkest scenario – where Medicaid patients are blocked from your clinics. What's the contingency plan? Appealing to the private sector for funds?
We have wonderful supporters, and always have. But you can't privatize the public health care system. It will be a state-by-state plan. Some of our states have been shut out of programs for a long, long time, and they're equipped in a different way than in states where they currently see tens of thousands of Medicaid patients. We'll be working at the state levels with governors and legislatures to make sure that patients get care. But first we're working [at the federal level] to make sure that doesn't happen.
Is there anything that gives you hope?
One of the the most heartening, but somewhat perplexing, things is the number of Trump voters who are deeply concerned now about losing access to Planned Parenthood. The polling shows this — supporters of Donald Trump have supported access to and federal funding for Planned Parenthood. So our job right now is to ensure that the incoming president recognizes the devastating impact it would have on real people and their lives — and how important it is not to go that direction.
Will there be an effort to block Rep. Tom Price from becoming Health and Human Services secretary?
We're very concerned about his record. We are definitely looking forward to the hearings, to educate members of Congress as well as the American people about the extreme positions he has, not only about attacking Planned Parenthood and overturning the Affordable Care Act – he's absolutely unsympathetic to the need that women have for basic family planning.
I talked to Chad Griffin, the head of the Human Rights Campaign, recently. He said one of the first things he did in the predawn hours after election night was call you. Can you take me back to that phone call, and what it says about progressive groups working together in the age of Trump?
We were all up very late that night and early that morning. Chad and I have become very close, not only in working on this campaign but in the work we do together. We have a lot of alignment in terms of the communities we serve and the folks we engage as leaders. We see an enormous number of LGBT patients; we've expanded trans services across the country. The call was poignant – but also a recommitment that the work we have to do together is not about any one election, but about the long haul.
I will say, I've been doing this work a long time, not always at Planned Parenthood but in various progressive organizations. If there is one thing that his election did for the progressive community, it served as an enormous bonding experience. Over the last month, we've had meetings of some of the major progressive organizations. Folks recognize that our issues, our organizations and frankly our activists are all connected. Planned Parenthood patients are immigrants, they're Muslims, they're LGBT folks, they're single parents, they're students. And all of the attacks that folks are anticipating going forward are ones that are already engaging our activists as well. We feel a particular responsibility to stand with those who've stood with us as we've been under attack these many years.
We've talked about the GOP assault. Are there still opportunities for you to play offense in blue states – to carry the ball forward despite Trump?
A lot of the action is going to be in the states, and that's where where we can win. California is a state where we've really expanded access to care. In other states, we've expanded access to HIV care or trans care or new kinds of birth control that no one else is doing. Part of winning, to me, is not only in an electoral or legislative sense. It is finding new ways to take away barriers for folks who are looking for information, education or health care services. Sex education is at risk in this country, based at least on the nominee at the Department of Education. But we provide sex ed to about six million people a month online. We're going to have to be more creative and more disruptive.
I do believe that the world only rolls forward. That's the way we have to look at this particular moment in time: as an opportunity to grow our movement like never before. If there's one challenge that progressive organizations jointly share right now, it's [how to harness the energy from] the outpouring of people who want to stand up and lead and be counted, and really put forth a different vision of the way this country should be going.
This interview has been edited for length and clarity.