New Jersey's family planning health centers are bracing for reduced hours, layoffs, and even closings after Gov. Christie's veto of a bill to restore $7.5 million for women's health services.
Planned Parenthood of Southern New Jersey, for example, expects patients will have to wait or travel longer to receive care following the elimination of state funds, which make up a quarter of the organization's budget.
Since the spring, advocates and a group of lawmakers had pressed the Christie administration to reconsider eliminating all state funding for 58 family planning centers. They have argued that the centers save the state money in the long run - mainly in Medicaid costs - through preventive care, while also reducing abortions and unwanted pregnancies.
Christie says that many tough choices were made in putting the state budget together, and that women's health services are still available. But women's health advocates see the cuts as a setback for New Jersey.
Clare Coleman, president and chief executive officer of the National Family Planning and Reproductive Health Association, said no other governor has targeted family planning in this way.
"New Jersey has that reputation for being more progressive, and I think for that reason it's been terribly surprising to the service providers in the state, because they feel like they have proven their programs are cost-effective and good for public health," she said.
FamCare Inc. plans to close centers in Millville and Vineland, reduce operations in Bridgeton from three days a week to one, and end services at Rowan University.
The region it serves has high rates of cervical and breast cancer, teen pregnancies, and sexually transmitted diseases, in addition to many migrant workers with no health coverage, noted Marilyn Lindenmuth, director of health services.
"We're so rural," she said. "Our family incomes are very low. They don't have health insurance."
With public transportation also limited, "most will probably go nowhere - they probably will not get health care at all," said Lindenmuth.
Michele Jaker, executive director of the Family Planning Association of New Jersey, estimated 100 layoffs will take place statewide.
New Jersey's family planning centers last year provided reproductive and preventive health care to 126,903 women and 9,461 men, most of them without health insurance, according to the Family Planning Association of New Jersey.
The clinics provide low-cost birth control, breast exams, pap smears, screenings for sexually transmitted diseases, and prenatal care.
Planned Parenthood is seeing more women who had considered themselves middle-class but have lost their health insurance in the recession, according to Joyce Kurzweil, executive vice president of the organization's South Jersey office.
Leaders of Planned Parenthood said its centers - in Cherry Hill, Camden, Atlantic City, and other towns - serve as a gateway into the broader health care system for low-income women. Those patients can then be referred to other providers for health problems unrelated to reproductive care.
The Guttmacher Institute, which sent a representative to testify before lawmakers last week, determined in a May study that publicly supported family planning clinics save taxpayers $3.74 for every $1 spent providing contraceptive care.
After Christie cut family planning in the state budget, the Legislature granted final approval last month to restore the money by transferring funds from a state employee prescription drug program. The bill would also allow New Jersey to expand Medicaid to cover family planning services - as 27 other states have done - and receive $9 in matching federal funds for every $1 spent by the state.
The measure would have prohibited funds from going toward abortions, though state GOP chairman and Morris County Assemblyman Jay Webber and other opponents were unhappy that funding would go toward organizations that provide them.
Christie, who had the state's Medicaid expansion application withdrawn earlier in the year, said in his July 23 veto that he was not persuaded New Jersey needed to amend the program at this time, noting the significant funds needed for start-up.
Christie disputed that $7.5 million was available from the prescription drug program. In his veto, he countered that residents can access those services through a variety of clinics in addition to Federally Qualified Health Centers (FQHCs), which are required to provide reproductive health care.
Critics say that those centers are already financially struggling, and will face additional challenges with tens of thousands of adults losing health insurance through the FamilyCare program, which also provided birth control.
State Sen. Loretta Weinberg (D., Bergen) and Assemblywoman Linda Stender (D., Union) have led the fight against the cuts, testifying before fellow lawmakers, meeting with the governor's office, and holding news conferences to highlight the issue.
U.S. Sen. Frank Lautenberg (D., N.J.) and U.S. Rep. Frank Pallone (D., N.J.) also have spoken out against the elimination of family planning funding. Some will continue to press the issue.
Assembly Speaker Sheila Oliver (D., Essex) said in a statement Tuesday that vetoes of bills to restore funds for family planning and FamilyCare would force residents to use emergency medical services as their primary form of health care.
"To deny uninsured and underinsured women access to the same type of preventative treatments women with insurance can receive with a phone call and a doctor's visit is a gross inequity bordering on classism, and we Democrats in the Assembly do not think it should stand," she said.
Overriding the veto would require two-thirds majorities from both legislative chambers. Unlike the Senate, the Assembly did not pass the $7.5 million restoration bill with a veto-proof majority. Democrats in the lower house would need the support of seven Republicans for an override.
A spokesman for the Assembly Republicans declined to say whether any members of the caucus would vote for such a measure.
"I think there are many Assembly [Republicans] who are in lock step, in fear of retribution of some sort," said Assemblywoman Pamela Lampitt (D., Camden).
Lampitt noted Planned Parenthood's success in Camden, where last year just two out of 60 children born to mothers in the prenatal care program were underweight. She said the collective goal should be to ensure healthy babies, given the cost of providing special education and other services to children born with health problems.