Mergers in Planned Parenthood Aim at Consolidating Power and Expanding Program

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June 10, 2013; Politico

NPQ has, for some time, been covering a trend of consolidations among affiliates of national networks. As you might see here and here, there is often fallout—losses as well as gains. Planned Parenthood has already consolidated a lot, reducing from a high of 200 affiliates to the current 73 nationwide.

According to The Republic, the statewide offices of Planned Parenthood in Kentucky and Indiana will merge in early July. The merger is meant to expand the services of Planned Parenthood throughout the two states, especially in hard-to-reach rural areas. Kim Greene, Board Chair for Planned Parenthood of Kentucky, stated, “Our combined strength and depth is going to make us much better able to serve the needs of current clients in both Kentucky and Indiana, and to participate in meeting much of the unmet need that still exists.”

The latest round of mergers has stemmed largely from aftereffects of the federal Affordable Care Act, Greene said. The law’s structure favors larger health organizations “that can take advantage of economies of scale.” But is this merger intended also to strengthen both their policy apparatus and their political armor?  Indiana Governor Mike Pence, a strong opponent of Planned Parenthood since his days as a Congressman, stated in 2011, “I am interested in doing what we can, in the balance of this fiscal year, to end public funding of Planned Parenthood.” Cecile Richards, Planned Parenthood President, said of Pence, “He’s the only one I know of who has been so completely obsessed with Planned Parenthood.”

Fast forward two years later, and Pence is now Governor and the state offices of Planned Parenthood have merged with its Kentucky counterpart, perhaps with an eye to the existing political dynamics. Most recently, the Governor is weighing the state’s legal options toward a recent U.S. Supreme Court ruling against the state, stemming from a recent law that stripped Medicaid funds from the organization.

Additionally, as ObamaCare approaches critical 2014 implementation deadlines, larger and stronger organizations may be better suited to work within the new healthcare law, and the latest wave of Planned Parenthood mergers have reportedly been informed by that. According to Greene, “The law’s structure favors larger health organizations that can take advantage of economies of scale.”

While the merger of these two statewide agencies may achieve greater impact against potential political and policy headwinds, the merged entity believes it is ready. As Greene stated, “I guess we’re always kind of expecting pushback from everything that we do. But we’re ready. Those folks have dealt with it a long, long time and very successfully.”

You may remember that NPQ reported that the Sunlight Foundation ranked the outcomes of various groups that were involved in the last election and found that Planned Parenthood Votes and Planned Parenthood Action had the best ROI of any of the external groups involved in more than one election.

NPQ would love to hear from people in the field. How are you experiencing the mergers in Planned Parenthood?—John Brothers

  • James W. Sedlak

    To understand the Planned Parenthood mergers, you have to go back to 1994. Planned Parenthood had 164 affiliates, Clinton was president, and Hillary was trying to move the country into national health care. As it is today, Planned Parenthood was a big part of the health care thrust. It put together a plan to reinvent its clinics and expand its services. Planned Parenthood ran into a great deal of internal dissension. Some called it chaos.

    Smaller affiliates revolted against the planned changes while, for the most part, larger affiliates embraced them. The Clinton health plan never went through, but Planned Parenthood began an effort to reduce the number of affiliates and to make the remaining affiliates more homogenous As a result it began to merge smaller affiliates into larger ones – with a goal of having every affiliate have at least an $8 million gross income.

    One of Planned Parenthood’s problems was that it had many affiliates that did not want to do abortions. Three years ago, Planned Parenthood issued an edict that said by the beginning of 2013 every affiliate had to have at least one clinic that did either surgical or medical abortions. Two of its affiliates resigned from the federation over this requirement.

    In January 2013, there were still six Planned Parenthood affiliates that had not complied with the mandate. Planned Parenthood of Kentucky was one of them. One of the results of this merger is that the new, combined affiliate does do abortions at several locations.

    While the Affordable Care Act may have some bearing on these mergers, it must be noted that Planned Parenthood went from 164 to 99 affiliates before Obama was first elected. It has gone down another 26 since 2008. In that same period – from 1994, it closed a net of 185 clinics. Historically, Planned Parenthood mergers rarely result in increasing its number of clinics.