Pennsylvania is one of 14 states that directly fund the antiabortion movement, some of it with money diverted from cash assistance for people in poverty.

Overall, the state has allocated tens of millions of dollars to Real Alternatives, a private nonprofit in Harrisburg that funnels money into crisis pregnancy centers. Such facilities advertise services offering pregnancy and parenting support to low-income women with the fundamental aim of dissuading them from getting abortions.

Though legal, the centers are said to use deceptive tactics and medical disinformation, sometimes misleadingly presenting themselves as abortion clinics.

Those findings are part of a new report, “Designed to Deceive: A Study of the Crisis Pregnancy Industry in Nine States,” by a group known as the Alliance: State Advocates for Women’s Rights & Gender Equality. The Women’s Law Project, with offices in Center City and Pittsburgh, is one of the Alliance participants. The report is embargoed until Tuesday, and few details have been disseminated.

In a statement, Real Alternatives said its service providers “are motivated by the love of God to serve women in unexpected pregnancies so they do not feel they must abort their pre-born child. ... Real Alternatives facilities meet rigorous ethical standards.”

The Alliance is releasing its report now, it says, as attempted abortion bans in Texas and elsewhere combine with an increasing number of crisis pregnancy centers being underwritten by public funds, making this moment in America “the most hostile era for reproductive freedom in decades.”

» READ MORE: Abortion is a key issue for Pa. Democrats, and it could supercharge the 2022 midterms

Legislators and Wolf administration officials say that little can be done to change an antiabortion ethos that is not just baked into Pennsylvania politics but also is required under state law.

Nevertheless, said Susan Frietsche, senior staff attorney with the Women’s Law Project, “Pennsylvanians deserve to know they’re quietly being forced to fund the crisis pregnancy center industry.”

An Inquirer examination of state records shows that, for decades, the Pennsylvania Department of Human Services has financed antiabortion activities by allocating more than $113 million in state money and $21 million in federal dollars to Real Alternatives.

In turn, the nonprofit hires a group of crisis pregnancy centers as vendors who are reimbursed “to provide pregnancy and parenting support services to women,” according to a statement from Real Alternatives.

Throughout the state, there are 160 or more crisis pregnancy centers, 28 of them part of Real Alternatives, according to the Women’s Law Project. DHS has a different count, however, saying Real Alternatives has 81 centers, including 12 in Philadelphia. Because centers are unregulated, it’s difficult to resolve the discrepancy.

Maternity homes and adoption centers are also part of the Real Alternatives network. The Inquirer reported on allegations of financial irregularities in the organization in 2018. A court case is ongoing.

» READ MORE: Dispute questions anti-abortion group's use of taxpayer dollars (from March 2018)

Pennsylvania is one of only nine states that route a portion of federal cash assistance from mostly women and children in dire poverty — disproportionately Black and people of color — to Real Alternatives. That money, formerly called welfare, is known as TANF (Temporary Assistance to Needy Families) and is disbursed to about 65,000 Pennsylvanians — 49,000 of them children. Pennsylvania paid out $514 million in TANF dollars in 2019-20, state figures show.

The state has redirected $1 million a year since 2001 in TANF money to Real Alternatives, state records show. In fact, Pennsylvania was the first state in the nation to move cash assistance money to antiabortion programs.

“That’s an abysmal stewardship of public dollars,” said Mariana Chilton, director of the Center for Hunger-Free Communities at Drexel University’s Dornsife School of Public Health.

“The state is essentially stealing money from people who are already impoverished, and diverting it to right-wing groups who profit off pretending to do something for women and children. It’s a form of racism and sexism.”

Although the annual $1 million diversion is relatively small, it still has consequences, said Signe Espinoza, interim executive director of Planned Parenthood Pennsylvania Advocates, the agency’s lobbying arm. “Budgets are moral documents,” she said. “Even an allotment of $1 a year means our state is prioritizing antiabortion rhetoric with money that should be going to poor folks.”

DHS is mandated by the state to make funds available for the alternative-to-abortion services program (sometimes referred to as alternatives-to-abortion).

A statement on the DHS website says the “program promotes childbirth rather than abortion ... and provides ... services regarding ... parenting and chastity.” The website lists Real Alternatives under the heading “Where to Go for Help.”

Real Alternatives is the sole contractor receiving money for running the alternative-to-abortion services program. It is headquartered in the state capital in a nondescript office plaza, near a thrift shop.

There are 17 free-standing abortion clinics in the state, five of which provide medication abortions only, according to the Women’s Law Project. Although organizations that perform abortions such as Planned Parenthood have received state funding for family planning, they aren’t allocated any money for abortions. Their funding comes mostly from donations and patient services, a Planned Parenthood spokesperson said.

» READ MORE: The Supreme Court doesn’t block Texas’ abortion law, sets a hearing

Controversy

The 2,500 to 3,000 crisis pregnancy centers nationwide are steeped in controversy.

A congressional report in 2006 found that 87% of centers that investigators contacted “provided false or misleading medical information,” such as saying abortions are unsafe, despite evidence to the contrary.

Pennsylvania’s choice of moving money earmarked for its neediest to antiabortion operations underscores a “disconnect” plaguing low-income Americans, many of them Black and women of color, said LaDonna Pavetti, a vice president at the Washington, D.C.-based Center on Budget and Policy Priorities.

“This funding is used to convince a woman to have a child,” she said. “But when the child’s born, the state provides few resources. A family of three gets an average of $403 a month in TANF in Pennsylvania, which hasn’t increased since 1990. It’s egregious.”

In Pennsylvania, Real Alternatives says it has served 50,000 women using TANF dollars alone and 331,000 women in total during 1.7 million service visits since it opened.

A 25-year-old Upper Darby woman who asked for anonymity said she found solace in a crisis pregnancy center called Birthright of West Chester. It’s not under the Real Alternatives umbrella but shares the same goals.

“I was pregnant at 19,” she said. “I never wanted an abortion, but I needed to make my baby safe. The Birthright people helped me put my child up for adoption. It was beautiful.”

Jill Hartman, executive director of A Woman’s Concern, described as a pregnancy support center in Lancaster, said women who “choose life deserve this network of people helping them.” Hartman, who said her center receives an average of $100,000 annually from Real Alternatives, added that it’s difficult to absorb the anger of abortion-rights advocates.

“How would you feel if everyone says you have an agenda to shame others?” Hartman asked. “It hurts.”

» READ MORE: In Philadelphia and nationwide, Women’s March targets Supreme Court with abortion on the line

Developed in 1995

Pennsylvania began funding an antiabortion initiative with $2 million in 1995. It was developed under Democratic Gov. Robert Casey, an abortion opponent, with the help of the legislature’s “pro-life caucus,” according to a historical narrative by Real Alternatives.

“Abortion is unjust in every sense of that term,” Casey said in 1992. “And the Democratic Party ... has been at the forefront of that injustice.”

In 1996, Congress decided cash assistance would come from block grants given to states, which had the right to re-channel the money.

That year, then-State Rep. Joseph Pitts (R., Chester County), a leading antiabortion legislator, started the process to secure funds allowing Gov. Tom Ridge to first award Real Alternatives a contract for $2.1 million in 1997.

In the most recent budget, Real Alternatives has received $6.2 million in state money, budget figures show.

Kevin Bagatta, the CEO of Real Alternatives, makes about $300,000 annually, tax documents show. About half comes from Pennsylvania, according to the nonprofit, which did not specify the source of the rest. With an affiliate in Indiana, Real Alternatives also consults in other states, experts say.

The nonprofit had a contract to operate in Michigan that Gov. Gretchen Whitmer vetoed in 2019.

Officials mum

Asked why Pennsylvania supports antiabortion entities, state officials offered little insight.

Jonathan McVey, deputy policy director of DHS, said in an interview that his agency “has been required to fund [alternative-to-abortion services programs] through the fiscal code. We don’t have the alternative not to.”

The code, created by the legislature, dictates how budget money can be spent. It says any state-funded alternative-to-abortion project “shall not promote, refer for, or perform abortions or engage in any counseling which is inconsistent with the appropriation... .”

A request for comment about Real Alternatives from Gov. Tom Wolf, who has said, “I will veto any antiabortion legislation that lands on my desk,” garnered only a spokesperson’s statement referencing the code.

Over time, the Republican-led legislature has continuously allotted money for DHS funding of Real Alternatives.

Asked for its rationale, neither Pat Browne (R., Lehigh), Senate Appropriations Committee chairman, nor his counterpart in the House, Stan Saylor (R., York), returned phone calls.

Rep. Kathy Rapp (R., Warren) explained the commitment to Real Alternatives this way: “Legislators have long voted for it because they believe in life.” Although she acknowledged Planned Parenthood doesn’t get state funding for abortions, she said: “If we’re going to fund Planned Parenthood at all, there’s no reason we can’t fund pregnancy centers.”

Sen. Amanda Cappelletti (D., Montgomery/Delaware), cochair of the legislature’s Women’s Health Caucus, explained, “There’s no will in Harrisburg to change any of this.”

Alleged irregularities

Real Alternatives has been a subject of contention for years.

In 2017, then-Auditor General Eugene DePasquale said the nonprofit had reimbursed its service providers for just 97% of the program services they rendered, withholding the remaining 3%. And DePasquale said Real Alternatives used Pennsylvania taxpayer money for pregnancy centers in other states.

Real Alternatives’ executives said in 2018 they were “dismayed by the misrepresentation of our company’s outstanding accountability.”

Equity Forward, a national reproductive-rights group, has sued DHS for records related to Real Alternatives’ contracts. That effort is still in the courts. A DHS spokesperson said it’s resolved the issue of 3% offsets in an agreement with Real Alternatives. But, Equity Forward said, it’s unclear whether proper changes were made.

‘Fighting Satan’

Antiabortion advocate Robert Pearson created the first crisis pregnancy center in Hawaii in 1967. In a 1994 speech, he didn’t dispute that such centers, many affiliated with evangelical Christianity, pretend to be abortion clinics.

“We’re fighting Satan, who wants to kill the [pregnant woman’s] baby ... ,” Pearson said in his speech. The woman “has no right to information that will help her kill her baby. Therefore, when she calls and says, ‘Do you do abortions?’ we do not tell her, ‘No, we don’t do abortions.’”

Such a situation developed in Center City last November.

A woman sought the Philadelphia Women’s Center (PWC) for an abortion but inadvertently went to a nearby crisis pregnancy center with a deliberately similar name, according to Roxanne Sutocky, director of community engagement at PWC.

Rather than saying it wasn’t an abortion clinic, staffers at the facility kept scheduling the woman for an abortion, then postponing it, then rescheduling to delay the procedure and allow the pregnancy to develop. The woman eventually had the abortion, Sutocky said. The crisis pregnancy center didn’t return calls.

“It’s standard for women to tell us about this kind of confusion,” she said. “It’s been allowed by the state to proliferate in the dark. It feels like Pennsylvania hates poor folks.”

The crisis centers’ methods were highlighted in the Journal of General Internal Medicine in 2019: “While [crisis pregnancy centers] ... provide valued emotional, spiritual, and material (e.g., diapers and formula) support for some women, they often engage in practices that are dubious at best and unethical at worst ... [including conducting] medically unnecessary ultrasounds ... to dissuade women from abortion.”

To create confusion, antiabortion advocates will gather outside Planned Parenthood Southeastern Pennsylvania on Locust Street in Center City and “coerce patients to go to the nearby crisis pregnancy center down the block,” said Dayle Steinberg, president and CEO of the Planned Parenthood office.

Alhambra Frarey, a Philadelphia obstetrician and abortion provider, said a patient was told, as many are, that her medical abortion could be reversed with progesterone. The American College of Obstetricians and Gynecologists determined abortion-pill reversal is “not based on science and ... [doesn’t] meet clinical standards.”

As the antiabortion movement progresses, “it’s hard to believe Pennsylvania’s program has flown under the radar,” said Ashley Burnside, analyst for the Center for Law and Social Policy in Washington. “This is one of the most blatant misuses of TANF I’ve seen.

“A good question to ask is: ‘How is this allowable?’”