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Fake Clinics Are Not the Answer

Anti-abortion lawmakers are remaking the safety net for reproductive health care in their image of God.

Abortion rights activists outside of the Supreme Court, ahead of a ruling which activists say may have forced more than half of Texas’s abortion clinics to close.Credit...Mandel Ngan/Agence France-Presse — Getty Images

Ms. Grimes is a journalist and activist.

AUSTIN, Tex. — In its quest to “defund” Planned Parenthood and end access to clinical abortion care, the federal government under the Trump-Pence administration is poised to recreate a public health disaster that has blighted the already heavily damaged reproductive health care safety net in Texas, where lawmakers recently replaced seasoned medical providers with Bible-thumping grifters.

In 2016, an organization of crisis pregnancy centers applied for a Texas family planning grant. The Heidi Group told the state of Texas that with just $1.6 million in taxpayer dollars, it could transform itself from a small religious nonprofit that had never provided comprehensive reproductive care into Planned Parenthood minus the abortion referrals.

But the Heidi Group couldn’t make the transformation. Investigations are continuing, but state data suggests that the organization treated only a small fraction of the 70,000 Texas patients it promised to serve, even after being selected to receive a second round of state funding that would have funneled a total of over $6 million to the organization.

The Heidi Group’s failure to deliver was so egregious that a former employee told The Texas Observer, “That’s sinful, to take that amount of money and not use it for what it was supposed to be used for.”

And yet the Heidi Group’s founder, Carol Everett, is still in the mix. In January, as Ms. Everett’s state funding sources were drying up during investigations into the Heidi Group’s finances, she applied for federal family planning dollars — money from Title X, the program that Planned Parenthood has backed out of because of the Trump-Pence administration’s domestic gag rule that prevents providers from discussing abortion with their patients. When that application failed, Ms. Everett tried again in July, this time under a new name: Vita Nuova Inc.

At first glance, it is puzzling that someone at the center of such a public kerfuffle would seek to recreate the very conditions that landed her there, and on a bigger scale. But a closer look reveals the logic behind Ms. Everett’s efforts: What happened in Texas with the Heidi Group wasn’t a mistake, or bureaucratic blunder, or gamble that just didn’t pay off. It was supposed to be a new kind of government-and-faith-group partnership predicated on a shared ideology that, if not expressly religious, was rooted in conservative Christian beliefs and practices, and for which the state had been laying the groundwork for years.

When Texas booted Planned Parenthood out of publicly funded reproductive care programs in the early 2010s, journalists and activists — myself includedinvestigated the state’s claims that a hodgepodge of nonspecialist providers could fill in for Planned Parenthood, all coming to the same conclusion: Nope. As the years went on, the state’s own numbers showed that Texas’ safety net programs served many fewer patients than were seen by Planned Parenthood, culminating with the Heidi Group scandal.

Now similar efforts are being made at the federal level, and this time, funds are being awarded to a fake clinic organization from California with ties to none other than the Heidi Group.

Ms. Everett’s first application for Title X funding was made together with California’s Obria Group. Like the Heidi Group, Obria is led by one woman on a religious crusade, Kathleen Eaton Bravo, and first sought local funds (which it has been accused of misdirecting) before turning its attention to Title X.

Ms. Bravo has promised her supporters that Obria will never provide hormonal contraception, saying she’ll contract with other providers to fulfill that need, and the federal government liked her proposal. It awarded Obria $1.7 million, but gave nothing to the Heidi Group. Ms. Everett persisted with her next application as Vita Nuova, simultaneously filing suit against the federal government under the presumption that Vita Nuova will be denied Title X funds because it intends to refuse care to L.G.B.T.Q. clients, in violation of federal law (for now).

Ms. Everett and Ms. Bravo are hellbent (or perhaps, in their view, heaven-bent) on seizing an opportune political moment. Vice President Mike Pence, who was at the vanguard of the anti-abortion movement’s early attempts to defund Planned Parenthood, is now in a position to move federal barriers out of the way for these conservative Christian groups that say they can provide health care. Already, this administration has weakened federal protections against discrimination in health care, while instituting policies such as the domestic gag rule.

Moves like these make it clear that the administration’s intent is for those who rely on Medicaid and other public programs to be forced to seek care from faith-based providers who are tasked with delivering services that they not only have no experience providing, but which their leaders sometimes find morally repugnant or run contrary to their own stated religious values. Those services could include hormonal contraception, STI treatments for sexually active unmarried people, and fertility and adoption counseling for L.G.B.T.Q. people.

For years, conservatives have claimed to want to run governmentlike a business,” getting the public used to the idea that anyone but the government should run government programs. Now, we know who “anyone” is: those who espouse extreme right-wing beliefs on sexuality and regressive views of what it means to be an American family.

Discrimination is intended to be a feature, not a bug, of public services under the Trump-Pence administration. As we have seen in Texas, when providers who are best equipped to deliver health care services are replaced by ideologues who are more interested in biblical signs than vital signs, it will be low-income people, communities of color, and L.G.B.T.Q. folks who pay the price — literally, with their tax dollars, and bodily, as providers deny care according to their religious whims.

Andrea Grimes (@AndreaGrimes) is a journalist and activist in Austin, Tex.

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A version of this article appears in print on  , Section A, Page 27 of the New York edition with the headline: Faith-Based Clinics Aren’t The Answer. Order Reprints | Today’s Paper | Subscribe

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