‘Planned Parenthood Has a Good-Girl Problem’
If you need an abortion in New York City, you probably think you’re lucky: You live in one of the easiest places to get one in America. Though terminating a pregnancy has been outlawed or drastically restricted in 20 states since Roe v. Wade fell in 2022, it’s legal in New York through the 24th week with liberal exceptions after that. If you’re on Medicaid, the procedure or pills can be covered. You likely want to go to Planned Parenthood, where you won’t be judged. You might know the clinic on Bleecker Street, in the orange brick Classic Revival building featured, for years, in countless articles — a location that has trained generations of abortion providers. But that clinic, Manhattan’s only Planned Parenthood, shuttered permanently on Halloween.
The year before, in the summer of 2024, Planned Parenthood of Greater New York, the affiliate that ran the Manhattan clinic, had closed down three clinics upstate and one on Staten Island. That August, Bleecker Street stopped offering abortions after 20 weeks — a rare but sometimes needed procedure (in 2022, accounting for a little more than 2 percent of abortions in the city) — because it couldn’t afford an anesthesiologist for the deep sedation the clinic considered necessary. The patients who could still get abortions might remain awake during their procedures; you couldn’t know how much the nurses hated telling them that. Then, last January, the building’s boiler broke, after decades of deferred upkeep, and the clinic closed for 20 days. When it reopened, it stopped abortion procedures entirely, though it still provided the pills. In March, the building went up for sale for $39 million.
Now, with Manhattan closed, a New Yorker could go to one of the remaining Planned Parenthood clinics, one each in Brooklyn, Queens, and the Bronx. There are also, in Manhattan, a few independent clinics and the city’s public hospitals and sexual-health centers, which have ramped up provision since the fall of Roe. Some private hospitals and doctors’ offices also offer abortions, if you know where to look. But Planned Parenthood is the best known and most trusted — the leading provider of sexual-health services and abortions in the country. In 2022, almost one-fourth of all abortions in the city were performed by a Planned Parenthood clinic. More than one in six was at Bleecker Street. Yet PPGNY says it couldn’t afford to keep the clinic open.
The problem was bigger than New York. Planned Parenthood’s brick-and-mortar locations have been disappearing across the country for years. Over the past two decades, the total has dropped from more than 800 clinics to around 550, and Manhattan was only one of roughly 50 that closed in 2025. They’ve shuttered in red states, yes — including Texas, Indiana, and Louisiana, where abortion has been largely illegal since 2022 — but also in blue ones, such as Minnesota, Colorado, and Vermont, where it’s robustly protected.
It’s a shocking turn for an organization that, however embattled by the right, has been powerful and broadly popular for decades — a fixture of the health-care system for half a century and a key player in the country’s politics since the 1990s. Over the years, pollsters have asked people how they feel about the organization compared to other cultural institutions, to national figures, and even to public sentiment — to the political parties, for example, to the AARP, to former presidents, to the phrase “All Lives Matter.” Planned Parenthood has consistently ranked among the top. This may be because a huge number of people have visited its clinics. A report published in May said that one in three women surveyed had gotten care at a Planned Parenthood, and a poll from January 2024 found that half of all women in the U.S., and a third of all men, said they knew someone who had been helped by the organization.
But for years it’s been facing a funding crisis across its complex structure: a national operation, with a political advocacy arm, that oversees but does not fully control 46 regional affiliates, each managing a varying number of clinics. Providing health care to low-income people has never been easy, but in recent years, rising costs have outpaced revenue, especially reimbursements from private and public insurance. In the aftermath of the Supreme Court’s decision to strike down Roe, private donations surged almost 50 percent, but they returned to normal levels by the next year.
In the first few months of Trump’s second term, it took some significant blows. Some affiliates were locked out of government funding for family planning and preventative health care for allegedly violating the president’s executive order prohibiting the use of federal money to promote diversity, equity, and inclusion. Others, including PPGNY, were told they couldn’t use federal grants for teen-pregnancy-prevention programs unless they promised to comply with Trump’s executive orders on DEI and “gender ideology.”
Then, this past July, through Trump’s One Big Beautiful Bill Act, the right achieved its long-pursued dream of cutting Planned Parenthood off from the majority of its federal funds, effectively stripping the organization of Medicaid money — an estimated $700 million — for a year. This time, conservatives not only controlled all three levers of government; they also had fewer moderates, such as Senator John McCain, whose thumbs-down vote on repealing the Affordable Care Act had circumvented Planned Parenthood’s defunding during the first Trump administration. And though Planned Parenthood warned that the bill put as many as 200 clinics at risk of closing, the public response from its allies was far quieter than it had been in the past: They were exhausted, overwhelmed, and a bit disillusioned. The millions of dollars Planned Parenthood had spent lobbying over the past few decades had failed to protect abortion nationally, and Roe had been lost.
At the same time, the organization was seen by many in the abortion-rights movement as less relevant than it had been in the past. They believed it was overly cautious — it had resisted sending medication abortion to ban states as other groups had ramped up provision — and a trail of seemingly self-interested choices had infuriated allies to its left, leaving it with fewer defenders in its time of need. For years, since long before the second Trump administration, grassroots operations and leaders in abortion rights had accused Planned Parenthood of compromising the movement, its own core mission, and public trust — all for the sake of maintaining political power. It had continued to support politicians that failed to prioritize abortion rights, preemptively complied with hostile laws, and declined to fight them when they passed — even, in some cases, refusing to provide abortions in inhospitable areas when it was still legal to do so.
These complaints persist among key grassroots players, abortion practitioners, and activist lawyers, who tell me that Planned Parenthood has become more a barrier to their work than a partner. Planned Parenthood officials, meanwhile, have long defended the organization’s decisions, saying they’ve been necessary for keeping the doors open.
Though Planned Parenthood affiliates operate with a degree of independence, several critics blame the national organization’s leadership for setting the tone. Michele Goodwin, a Georgetown law professor and a former board member for a Southern Californian affiliate, says she wants Planned Parenthood to succeed — few other groups have the capacity to provide what it does to underserved communities — but, she tells me, “Planned Parenthood has a good-girl problem.” The national board especially: “It’s not wanting to seem to be enraged, bitter, upset, wanting to get along, not upset the cart. They fear speaking more loudly. Let’s just be of soft voice and maybe the members of Congress won’t be mean toward Planned Parenthood. Of course that never worked.”
Alexis McGill Johnson, PPFA’s President and CEO, tells me that so far, since passage of the One Big Beautiful Bill Act, the group’s clinics have continued treating Medicaid patients by reaching into donation reserves. In recent months, a handful of blue states, including New York and California, have agreed to pony up funds to make up the difference, but affiliates across the country still face an enormous shortfall — in the hundreds of millions per year. In September alone, Johnson says, the nationwide cost was around $45 million. “The reality is that’s not sustainable,” she says. “There is not a world in which we can continue to meet all of that need.”
Wendy Stark, the CEO of PPGNY, tells me, “When I talk to some of my colleagues at Planned Parenthoods around the country, the shared sentiment seems to be that this is the hardest moment that folks have faced in, let’s say, three decades.” Three decades ago, clinics were being bombed. For as formidable as Planned Parenthood has seemed, she says, the organization, and public-health services in general, are deeply vulnerable to the whims of the federal government, even in New York. “NYC still has a relatively robust ecosystem of sexual- and reproductive-health care,” says Stark. “Will we have that in a year? I don’t know.”
When Margaret Sanger founded the institutions that would eventually become Planned Parenthood in Brooklyn in the 1910s and 1920s, they did not have a “good girl” problem. They had a stay-out-of-jail problem. Sanger had been radicalized early in life — watching her mother, an Irish immigrant, give birth to 11 children and suffer at least seven miscarriages — and later, in her 30s, by her experience, working as a nurse on the Lower East Side, where women begged for help preventing pregnancies. Sanger became a socialist feminist and in 1914 published a magazine, The Woman Rebel, declaring on its front page, “I believe that woman is enslaved by the world machine, by sex conventions, by motherhood and its present necessary childrearing, by wage-slavery, by middle-class morality, by customs, laws and superstitions.” Sanger was charged with distributing “indecent” materials and, rather than face prosecution, fled to Europe. Ten months later, she returned to stand trial, but her renown and support had grown and the charges were dropped.
In 1916, she opened her first contraception clinic, in Brownsville, with a $50 donation from a fan in California. But Sanger did not support abortion rights and, from the beginning of her public-facing life, took pains to make that clear. Handbills advertising the clinic blared, “DO NOT KILL, DO NOT TAKE LIFE, BUT PREVENT.” Within ten days of its opening, an undercover female cop reported that the clinic was sharing information about contraception, which was barred under federal obscenity laws, and Sanger was arrested. During her 30-day sentence, she taught birth-control methods to her fellow prisoners.
“Through the 1920s and ’30s,” wrote one of her biographers, Ellen Chesler, “Sanger divorced herself from her radical past … and made her name virtually synonymous with the birth control cause.” During this period, she enthusiastically supported eugenics, one of the leading progressive crusades of the time, out of some mix of personal interest in limiting the reproduction of those she considered unfit — which she defined as “Morons, mental defectives, epileptics, illiterates, paupers, unemployables, criminals, prostitutes, and dope fiends” — and the hope that allying herself with the day’s leading thinkers would make her seem more moderate. (In the racial-justice reckonings of 2020, Sanger’s name was dropped from the Bleecker Street clinic.)
By the end of the 1930s, Sanger lost control of both her clinic and a birth-control organization she’d founded to an upper-crust crowd she disparaged as “drawing-room lizards.” They preferred the euphemistic term “family planning” to “birth control,” and in 1942, to her distaste, gave their new, unified institution the name Planned Parenthood. By mid-century, it was a respectable bipartisan cause that enjoyed federal funding. Prescott Bush, the Republican politician and patriarch of the Bush family, served as the treasurer of the first nationwide campaign of the organization (though later, when it cost him Catholic votes and election to the U.S. Senate, he regretted his involvement and his family would go on to deny it). When Prescott’s son George H.W. became a congressman, he championed Title X, the legislation that granted federal contraception funding to Planned Parenthood and similar organizations. (H.W. was consequently nicknamed “Rubbers.”)
Beginning in 1962, Planned Parenthood’s president Alan Guttmacher supported physician-controlled access to abortion, but the organization had a vexed relationship with the procedure through the early ’70s. As states started to liberalize their abortion laws, the organization slowly began to provide the procedures — first at a clinic in Syracuse in 1970. After Roe legalized most abortions nationwide, in 1973, the rise of the Christian right left only a few moderate Republicans wincingly supporting Planned Parenthood. Even George H.W. Bush dropped the organization when he became Ronald Reagan’s running mate in 1980.
Almost immediately after the Supreme Court opened the door to legal abortion, the federal government began inching it back, banning Medicaid funds from covering most abortions in 1976 and, in the years that followed, letting states restrict access by adding hurdles such as mandated counseling and waiting periods. In 1989, Faye Wattleton, Planned Parenthood’s first Black president, formed its national political advocacy arm to begin supporting candidates and legislation. That year, Time magazine wrote that the organization had taken off “the white gloves” and become “one of the nation’s most vocal and aggressive advocates of abortion rights.”
By the 2010s, defunding Planned Parenthood was at the forefront of the Republican agenda. And under the presidency of Cecile Richards, beginning in 2006, PPFA became even more aligned with the Democratic Party. (Richards was the daughter of former Texas governor Ann Richards and a former chief of staff to Nancy Pelosi.) In 2011, when Republicans retook the House and introduced a budget amendment to deny Planned Parenthood all federal money, House debate was dominated by the question — Representative Jackie Speier told her abortion story, a first for a member of Congress. The amendment passed in the House but failed in the Senate. During the height of the battle, Richards often emphasized that abortion made up only 3 percent of the services the organization provided.
In 2013, at the start of his second term, Barack Obama became the first sitting president to speak to a Planned Parenthood gala. Some state-level attacks on the organization stuck — that year, Texas rejected federal funding supporting Planned Parenthood — but it seemed to be riding high, by far the biggest and most powerful reproductive-rights institution. In 2016, a year when 98 percent of Planned Parenthood’s national PAC dollars went to Democrats, even Trump praised the organization. From the stage of a Republican presidential-primary debate, he echoed the centrist rhetoric pushed by Richards: “Millions of millions of women — cervical cancer, breast cancer — are helped by Planned Parenthood,” he said. “I would defund it because I’m pro-life, but millions of women are helped by Planned Parenthood.”
Shortly after his victory that November, according to Richards’s memoir, Richards met with Ivanka Trump and Jared Kushner at Trump’s New Jersey golf course, seeking any friend the organization could find. There, Kushner proposed a deal: Planned Parenthood clinics would be allowed to keep their federal funding under the new administration if they stopped performing abortions. Their federal dollars might even increase. Richards shot down the offer, but Planned Parenthood made it through the first term with its federal funds intact.
Richards stepped down in 2018 and was succeeded by Leana Wen, a physician and former Baltimore health commissioner. (Richards died of brain cancer last January.) According to Wen’s memoir, she won over Planned Parenthood’s hiring committee by pitching that the organization minimize abortion in its messaging even further and reintroduce itself as an apolitical health provider. Staffers revolted, seeing the approach as at once cynical and naïve — as if the group’s opposition would relent if it only presented itself in the right way.
Wen was ousted in 2019 after less than a year and replaced by Johnson, a longtime national board member. The organization’s second Black president, she would be in charge during the toughest stretch for Planned Parenthood in a century.
The Bleecker Street building was still technically open when I visited in early October, but it was eerily silent. The usual protesters were gone, as were the clinic escorts who used to shepherd patients past them — a once coveted role with a wait list. Only a couple of security guards remained, watching carefully as visitors approached. Inside, above the former clinic, on one of the administrative floors, the desks were mostly cleared. On some sat snow globes, still in their factory boxes, the words “Still I Rise” sealed in glycerin. “Stand With Black Women” posters hung on the walls, and cardboard boxes were piled in the aisles, marked for their destinations at the city’s remaining Planned Parenthoods.
Wendy Stark was still working there, and we spoke in her office. When the building’s sale was announced in March, anti-abortion activists had immediately declared victory. It didn’t feel great, she told me. “But the joke’s on them. Because we’re doing the care still. Just not right here.” She didn’t sound particularly convinced.
Most of the Bleecker Street staffers would soon be moving to positions at the Planned Parenthoods in Brooklyn, Queens, and the Bronx. The Manhattan clinic had been known for its community sex-education programs, but ten educators had been laid off in the spring; their federal grants had been revoked under anti-DEI and anti-trans executive orders. Some of the remaining staffers, whom I spoke to throughout the fall, were ambivalent about how to talk about their employer. One said, “Planned Parenthood is one of the most beleaguered agencies in the country, and so it’s probably not the time to hit them while they’re down.” She then proceeded to air her grievances anyway. Employees had been overworked, she said; top brass, at the national level, were overpaid; patients faced what she believed were unnecessary requirements before medication abortions, including extra paperwork and intrusive additional exams such as ultrasounds. (A spokesperson for PPGNY disputed that patients were subject to any unnecessary steps.)
Other staffers described themselves as sad and bewildered. One noted that patients had often talked about how well the clinicians treated them and had been tearfully grateful for the care they received at Bleecker. Another remembered wondering why Manhattan’s donor class hadn’t stepped in. “They opened that floating island,” she said. “Come on. They can support a Planned Parenthood.”
I asked Stark why a city full of wealthy liberals wasn’t enough to keep the clinic open, but she didn’t quite answer, saying only that private funds aren’t a long-term strategy. In recent years, Medicaid funds have made up a little more than a third of the organization’s revenue. Another third, roughly, has come from private donors, and the rest comes from patients who pay out of pocket or with private insurance.
A Bleecker Street staffer had told another journalist that the closure felt like Planned Parenthood was “waving a white flag,” and I noted this to Stark. “I know that people have a symbolic or emotional attachment to Planned Parenthood being in Manhattan,” she replied. “But sustainability is more important than symbolism these days.” Of the Greater New York affiliate’s 18 clinics, she said, the Bleecker building was the “largest real property asset by far.” I understood the short-term math, though it also sounded like burning the house for kindling.
Stark insisted that the clinics would still be able to serve the same number of patients overall. She’d been brought on at an unenviable time — in 2022, just a few months after the Dobbs decision. The onus was on New York and other blue states to provide abortion access to patients in states where it was banned or in dispute; it was new terrain both legally and logistically. At the same time, the Greater New York affiliate had its own problems. It was composed of what had previously been five independent chapters — one in the city and four upstate. They’d merged in 2019, agreeing to share revenue and be managed by a single CEO, a move some staffers say was intended to help rural clinics keep their doors open. In Manhattan, staff worried that they would be overworked caring for more people in order to subsidize the locations that received fewer patients. (The spokesperson for PPGNY said that patient revenue from denser areas does not subsidize rural clinics.)
Similar mergers were playing out among other regional affiliates across the country, resulting in some tortured geographies, including a “Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky,” which included parts of Idaho and Washington State and carried the equally unwieldy acronym of PPGNHAIK. Many internal and external critics saw the consolidation as prioritizing finances over local relationships.
In these same years, abortion care was being revolutionized. Planned Parenthood seemed reticent to contend with it. The two-pill regimen to end a pregnancy, or medication abortion, rather than the in-office procedure, had steadily been growing in popularity since its approval in 2000. The pill process takes longer, but it allows a degree of privacy — patients take their second pill at home — and as Dr. Gabriela Aguilar, PPGNY’s medical director, told me, some patients say it feels like the more natural of the two options. By the start of 2020, medication abortions made up more than half of all those in the U.S. Then, in the spring of 2021, as the COVID pandemic dragged on, the FDA began temporarily allowing abortion pills to be sent by mail, and that December, the allowance became permanent.
That same month the Supreme Court heard oral arguments in Dobbs v. Jackson Women’s Health Organization. Anyone listening to the justices’ questions could hear it: Roe was dead letter. Advocates began to plan for state abortion bans, and a handful of lawyers, doctors, and activists came up with a way to partially circumvent prohibitions: So-called access states could pass statutes protecting doctors in their jurisdiction who provided abortions to patients living in ban states and could refuse to comply with any red-state prosecutions. The laws — called “shield laws” — would safeguard both treatment of those who traveled to blue-state clinics for abortions and the remote prescription of abortion pills.
When the Dobbs decision finally came down in the summer of 2022, many shield-law activists were surprised to learn — from lawmakers — that in several states, including New York, Planned Parenthood did not support the shield laws covering telemedicine, a position that was never formally announced and was initially invisible to the public. Planned Parenthood wasn’t alone in its opposition — in New York State, it was joined by the other dominant players in reproductive rights: the New York Civil Liberties Union, the National Institute of Reproductive Health, and the American College of Obstetricians and Gynecologists — but Planned Parenthood was the most influential. When activists confronted Planned Parenthood leadership, one told me, “They tried to pretend that they just had questions. They would say, ‘This is an untested strategy — we don’t think this is a good law. We don’t think we should stick our necks out for something that we don’t think would work.’”
A person involved in advocating for the shield laws in New York said that the state’s Planned Parenthood affiliates had their own legislative wish list, which included passing the long-delayed Equal Rights Amendment, and wanted lawmakers focused on their priorities. Others who lobbied for the shield laws said they’d suspected from the start that Planned Parenthood’s opposition was driven by concerns over its own survival: The laws would effectively support low-overhead online clinics that could siphon away patients. “I get it,” said one lawyer who worked on shield laws. “These are business entities, and they need to be able to pay their employees and pay their rent. And if you’re a place that can just ship pills anywhere in the country from your living room, you’re going to be able to undercut the prices of a Planned Parenthood or an indie brick-and-mortar clinic.” The New York state advocacy arm of the organization called this claim “completely untrue,” saying “We have a strong record of supporting policy efforts that expand access to sexual and reproductive health care — regardless of where that care takes place.”
In June 2022, New York legislators passed a shield law that protected doctors who performed in-person abortions on ban-state patients but did not mention telehealth. In the next legislative session, a handful of advocates and a new coalition, including the Center for Reproductive Rights and smaller organizations, banded together. “We said, ‘Okay, we are willing to take the risk so just get out of our way,’” one of the shield-law advocates told me. “‘It’s not on you. It’s on us. So let us do this.’”
When it became clear that a new, more comprehensive law would pass protecting telehealth provision, Planned Parenthood issued a statement supporting it. The groups that had worked to make it happen saw the move as face-saving; Planned Parenthood didn’t want its name missing from a major success in expanding abortion access. “We could have passed it in that first session after Roe fell,” the same advocate said bitterly. Adding insult to injury, they said, a Planned Parenthood representative “showed up at the bill-signing ceremony as if they’d been there all along.” (In a comment, the state advocacy arm denied that it had worked against the shield laws and said that it had “contributed to informing the legislation.”)
In our conversation, Stark did not dispute that PPNY had opposed the shield laws. She said the organization hadn’t been against the theory of the laws but worried that they wouldn’t be sufficient to protect prescribers. She said, “I think the fear is always, Will they work and do they provide a false sense of confidence for providers?” What if doctors trusted the laws, put themselves on the line, and somehow got prosecuted anyway? What if the Supreme Court struck down the statutes?
One of the shield-law advocates told me they understood in part. “Planned Parenthood, in their defense,” she said, “has been the face and the target of the anti-abortion movement for so long”; it would be blamed for anything that went wrong in this new legal regime. And Planned Parenthood still had affiliates operating clinics in states such as Texas and Alabama, where officials had vowed to go after those who helped abortion seekers.
So far, there’s no evidence that the growth of telehealth abortion clinics has harmed Planned Parenthood’s bottom line; Stark, of PPGNY, told me it has not seen any reduction in demand. A doctor who provides abortions under shield laws told me this was unsurprising. “The shield-law providers reach people who could never get abortions before; for example, people who couldn’t afford to travel or take the time off work.”
The laws, in the words of the lawyer who pushed for them in New York, “have been successful beyond anyone’s dreams.” Between July 2023 and September 2024, 84 percent of the mail prescriptions sent by Aid Access, the best-known telehealth pill provider — some 14,000 prescriptions a month — were being sent to ban states. And as of this past June, almost 15,000 abortions a month were being provided under shield-law protections, the vast majority of them through telemedicine.
The trend toward pill abortions and abortion by mail seems unlikely to reverse. By 2023, medication abortion made up 63 percent of all those in the country, and by the first half of 2025, mail provision accounted for 27 percent of total abortions. Planned Parenthood, however, continues to do the vast majority of its business in person. In 2024, PPNY’s telehealth program accounted for only 562 abortions, less than 2 percent of what it provided.
And according to a staff member based in New York City, an in-person practitioner at Planned Parenthood can typically distribute only 15 to 20 abortion prescriptions a day, compared with Aid Access, where, a doctor there told me, they could prescribe 200 a day.
Planned Parenthood also still does not allow clinics to send pills to patients in ban states, although the shield laws have been working as designed. Last January, Louisiana indicted a New York doctor named Margaret Carpenter for providing abortion pills to a teen in April 2024. In a video statement, Governor Kathy Hochul affirmed her commitment to protecting Carpenter and other New York providers. “I am proud to say that I will never, under any circumstances, turn this doctor over to the State of Louisiana under any extradition request,” she said. A New York State judge upheld that decision.
Conservatives, however, continue to try mightily to pierce the shield laws. In early December, Texas extended its notorious “bounty hunter” law — which allows Texans to sue in-state physicians who provide illegal abortions — to let anyone sue any doctor who prescribes abortion pills to Texans. A case against a physician in California is already pending.
At the same time, the right is frantically pursuing ways to crack down on the broader flow of abortion pills. In September, Health and Human Services Secretary Robert F. Kennedy Jr. announced that the FDA would be conducting a “safety and efficacy” review of mifepristone. In early December, Bloomberg reported that the agency’s commissioner, Marty Makary, had told the employees to slow-walk the review until after the 2026 midterm elections.
When Republicans laid out their strategy to defund Planned Parenthood in this past spring in Trump’s budget-reconciliation bill, the organization seemed to react with far less urgency than it had in the past. Jessica Furgerson, a scholar of the reproductive-rights movement, told me, “There is a palpable difference in how Planned Parenthood is responding to the climate. It feels like they have accepted defeat.”
It did not help that Planned Parenthood had rankled smaller organizations. In 2024, 34 abortion funds wrote an op-ed for The Nation in which they accused Planned Parenthood and other larger national groups of taking more than their fair share of the cash available from foundations and individuals, only to “funnel that money into campaign bank accounts,” rather than directly support abortion seekers.
As the funding bill advanced, Senator Lisa Murkowski of Alaska, one of the last self-described moderates in the Senate, vowed to vote against any budget that would defund Planned Parenthood. But Republicans concocted elaborate ways to direct money to Alaska, and Murkowski folded. When the legislation passed, Planned Parenthood sued, and the case is still yo-yoing between district and appeals courts.
This fall, less than a decade after Cecile Richards rejected Ivanka Trump and Jared Kushner’s proposal that Planned Parenthood stop performing abortions, the organization’s national leadership briefly suggested that certain affiliates could opt out of performing abortions to bypass the new law. Another option was to stop accepting Medicaid patients, or appeal to their state governments to make up the loss.
In response, in late September, Planned Parenthood clinics in Arizona stopped accepting Medicaid, and Wisconsin’s clinics stopped providing abortions. (A month later, Wisconsin found a bureaucratic loophole and resumed.) But almost all affiliates opted to keep offering their usual care and to keep serving Medicaid patients. So far, affiliates in eight states have successfully lobbied for emergency state funding; in New York, Governor Hochul allocated Planned Parenthood nearly $35 million. In the short term, it may sustain affiliates in those states, but 22 clinics have closed nationally since the defunding was signed into law.
Even in this moment of crisis, Planned Parenthood has continued to alienate allies to its left. In mid-October, current and former staffers at the Southeast affiliate, which covers Alabama, Georgia, and Mississippi, began speaking to reporters and posting on social media about their new leadership team, particularly the interim CEO Mairo Akposé, who they said was hostile to trans rights and abortion itself. (Abortion is almost wholly illegal in Alabama and Mississippi and banned after six weeks in Georgia.)
Akposé and her team resigned two days before Christmas. By then, the Yellowhammer Fund, an abortion fund in Alabama and Mississippi, had announced that it would “no longer be providing travel support, direct funding, or referrals to ANY Planned Parenthood affiliate in the U.S.” Yellowhammer’s health-care-access director Kelsea McLain told me that she didn’t trust that patients coming from ban states would be safe in the hands of an organization that has allowed its leadership to be subjected to such “infiltration.” Even before Dobbs, she said, since at least 2019, Yellowhammer hadn’t funded abortions at Planned Parenthood because abortion seekers frequently reported that their appointments were repeatedly rescheduled, delaying treatment. McLain also accused Planned Parenthood of trying to keep abortion patients from going to other providers, even when Planned Parenthood could not help them. (Akposé and Planned Parenthood Southeast did not respond to a request for comment.) Like other critics, she took issue with the fact that the organization, despite all its failings, has carried on using every new restriction as a fundraising opportunity. A representative for PPFA said: “This is absolutely inaccurate, an unsubstantiated allegation, and a gross misrepresentation of all Planned Parenthood organizations’ deep and abiding commitment to ensuring everyone can get access to the full spectrum of sexual and reproductive health care, including abortion.”
Johnson responded to the claim that Planned Parenthood had put its own interests first, saying that its decisions “should not be seen as prioritizing survival, but prioritizing access to the care we are all fighting for.” When I spoke to her in December, she resented the idea that the organization had played it safe and attempted to accommodate moderate and right-wing distaste for abortion. “I don’t see anybody operating in a good-girl mode,” she said, “or being led by politicians.” As in so many of her responses, her elaboration was vague: Planned Parenthood, she told me, has been “driving conversations around ensuring that people are fighting wholeheartedly for abortion access and care.”
When I asked Johnson why the organization had not only actively opposed the shield laws but has continued to refrain from providing abortions to ban states via telehealth, she paused for a long time, then said, flatly, “Planned Parenthood follows the law, full stop.” There were others, she said, “people who aren’t responsible for ensuring the existence of a nationwide reproductive health-care system, who would’ve made different decisions.” When I responded saying that the idea behind the shield laws was to allow providers to treat patients without breaking laws, she pushed back: “These protections are largely untested. There are providers who are prescribing to patients in other states — they are meeting that need. I would say at this point where we are, it’s not safe for Planned Parenthood to follow suit.”
When I asked her about the organization’s plans for surviving its current financial crisis, her reply was long and winding but seemed to translate to more cuts and the hope of being bailed out by donors. She added that the organization was considering pursuing a constitutional amendment to explicitly protect reproductive freedom, but most of what she said seemed to underscore Planned Parenthood’s essentially reactive position, whether to bolder initiatives from the abortion-rights grassroots or to attacks from the right, which wants to see access obliterated.
Some advocates told me they were glad that Planned Parenthood is smaller and far less powerful than it used to be — that it was a good thing not to have any kind of centralized control of the movement and definitely not from New York or Washington, where PPFA is based. Yet Planned Parenthood remains a key resource. The majority of abortions nationwide are still provided in person, and you can’t get an IUD, a pap smear, or an STI test via telehealth. In many places where Planned Parenthoods have closed, they have been replaced by Christian operations, which call themselves clinics but sometimes do not even provide basic reproductive-health services or employ licensed medical professionals. Some of these outfits have received federal funding that previously went to Planned Parenthood.
Some of Planned Parenthood’s vocal critics worry about what could be lost if clinics continue to shutter. Chelsea Williams-Diggs, the executive director of the New York Abortion Access Fund, was the lead author of The Nation op-ed reprimanding Planned Parenthood and other national operations. But, she said, “the advocacy, the community building, the youth work, the sex ed — there are so many great things that Planned Parenthood does that nobody else does.”
Johnson told me that no other organization provides affordable reproductive-health care at the high quality that Planned Parenthood offers. “No one is fighting to come into Planned Parenthood’s market and serve patients with the dignity and respect that they deserve at little-to-no cost,” she said. “And that has been very, very important to preserve.”
For now, it seems the organization plans to hold on to the mast through the storm. How long that will take is unclear. Soon there may be a Democratic Congress and a Democratic president; maybe someday there will be a Supreme Court that isn’t stacked against reproductive freedom.
In early December, the old Bleecker Street building sold to a developer who, according to the broker, was planning to build luxury condos.
Stark told me that she hoped to bring Planned Parenthood back to Manhattan — a new clinic, one built for the future. “One day when the tides change.”
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