With a Zika outbreak in Florida raising concerns about the exposure of pregnant women and those who may become pregnant, a set of clinics that many women use to get health care, birth control, prenatal care and abortions faces possible funding cuts that some experts worry could harm efforts to stem the spread of the virus.
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The state funding cut to Planned Parenthood health centers in Florida was at least temporarily halted through a court order on June 30. But some medical experts worry that if the court's preliminary injunction on a new state law ordering the cut is ultimately overturned and the law takes effect, low-income women who depend on Planned Parenthood for health care could be at greater risk for contracting the Zika virus and passing it along to their unborn children.
Florida Gov. Rick Scott in March signed into law the measure that would end all state funding for preventive health care services at any clinics that also provide abortions. The law also imposes certain restrictions on abortions and abortion providers. State funding for abortions is already prohibited except in cases of rape, incest or to save the life of the mother. But this law goes further by eliminating all state funding for health clinics that also offer abortions.
Florida's Planned Parenthood health centers serve about 80,000 patients a year at 22 clinics, all but seven of which are licensed to perform abortions, according to the executive director of the Florida Alliance of Planned Parenthood Affiliates.
The new law comes as Florida deals with its first outbreak of locally transmitted Zika virus, with 15 people infected in North Miami.
In the Miami-Dade area alone, three of the four Planned Parenthood centers provide abortions and would therefore be directly affected by a state funding cut, according to Planned Parenthood officials.
Planned Parenthood challenged the new law in court on the grounds that it put an unconstitutional burden on clinics providing abortions, according to a motion filed by Planned Parenthood. And on the day before the law was supposed to take effect on July 1, U.S. District Judge Robert Hinkle slapped a preliminary injunction on the funding cut.
"The defunding provision goes further and refuses to fund services that are wholly unrelated to abortions," the judge wrote in his decision.
Dr. Hal Lawrence, president and CEO of the American Congress of Obstetricians and Gynecologists, said he is concerned that a funding cut to Planned Parenthood clinics could give low-income women less access to birth control that can help them guard against unintended pregnancies in the face of the Zika threat.
“Planned Parenthood for decades has provided ongoing well-woman services and contraceptives to millions of women in the U.S. and has been oftentimes the best access for some underprivileged women to get access to contraception,” Lawrence said. Noting that approximately half of all pregnancies are unplanned, he said reducing access to birth control could increase the number of unintended pregnancies among women exposed to Zika through travel, sexual contact, or the new local outbreak.
“More pregnant women might get Zika, and more children would then be at risk for significant neurological problems,” he said.
Florida is home to many people who have emigrated from countries in Central and South America dealing with Zika epidemics or who travel to these countries, potentially exposing them to the virus. At least 55 pregnant women have been diagnosed with Zika in Florida. One infant was born in the state with Zika-related microcephaly. Except for the 15 people infected in the local outbreak, most cases of Zika in Florida are related to travel out of the state, according to the federal Centers for Disease Control and Prevention.
The fight over the Florida law comes at a time when Republicans and Democrats in Congress are at odds over a bill to grant $1.1 billion for a federal Zika response.
President Obama has requested $1.9 billion for Zika funding, but Congress has passed no bills with anything near that amount. The Senate passed a $1.1 billion deal in June, but the House’s approval of its own $1.1 billion in funding was filibustered by Democrats, who argued that they were left out of negotiations on the bill and that the measure would take funds away from other health programs and bar any availability of funds for birth control. One key issue is that the House bill would allow hospitals and public health clinics to get the additional funds, but would exclude women's health centers like Planned Parenthood.
Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, the state organization's lobbying and advocacy arm, emphasized that Planned Parenthood health centers are active in trying to stem the Zika outbreak.
The clinics are referring patients suspected of carrying the virus to public health authorities, Goodhue said. They are also posting fliers about Zika in English and Spanish and providing further information to patients. And, Planned Parenthood is training its clinicians and other staff members in Florida about the virus, she said.
“If we are prevented from being able to provide care it is certainly a big problem," Goodhue said. She said “as many as tens of thousands of people could be affected” by the state law's funding cut.
“This legislation impacts a targeted population" of low-income women who "may not receive care elsewhere,” she said.
State Rep. Dennis Baxley, one of the state legislators who introduced the bill that would cut Planned Parenthood funding, said he still supports the new law even after the local outbreak in North Miami.
"A lot of good research went into the construction and language of the law, and it will withstand scrutiny," said Baxley, a Republican representing eastern Marion County. "It is not unusual for Planned Parenthood and other organizations to challenge anything we do in this arena and find a judge that wants to legislate from the bench.”
He also said he hasn’t seen a full discussion of how the bill might affect efforts to prevent Zika and “would wait to see how that discussion unfolds to see if there is any relationship.”
The governor's office declined to provide comment about that aspect of the law that cuts funding for Planned Parenthood clinics, but stressed other Zika-prevention measures the governor has pushed.
“Governor Scott used his emergency executive authority to allocate $26.2 million in state funds for Zika preparedness, prevention and response in Florida," spokeswoman Jeri Bustamante said. "If it becomes clear more resources are needed, we will not hesitate to allocate them.”