Several states have begun picking up the tab for family planning services at clinics run by Planned Parenthood, which last year quit a $260 million federal funding program over a Trump administration rule prohibiting clinics from referring women for abortions.
States including New Jersey, Massachusetts, and Hawaii already are providing new funding, and Democratic governors in Connecticut and Pennsylvania have proposed carving out money in state budgets to counter the effects of the national provider's fallout with the Republican presidential administration.
The proposals have stirred political debates over abortion at the state level, with some opponents claiming it is a government endorsement of abortion and an inappropriate use of taxpayer money.
Connecticut Gov. Ned Lamont earmarked $1.2 million for Planned Parenthood in his new budget proposal. The executive director of the Connecticut Catholic Conference, Christopher Healy, criticized it as a purely political act.
"Where is the pressing need here to do this?" Mr. Healy said, arguing Planned Parenthood does not need taxpayer money. "They have the ability to raise money."
Mr. Lamont said he wants to help cover an expected shortfall for Planned Parenthood to ensure women in Connecticut have access to all the health services they need. A spokesman for Mr. Lamont said the administration doesn't want the abortion debate to stymie access to things like contraception and cervical cancer screenings.
"Look, this is the law of the land. Here in a state like this, we believe that abortion rights are right, and we believe they ought to be affordable for folks who otherwise might not have that availability," Mr. Lamont said. "So I think it's the right thing to do."
Nationwide, about 4 million women across the U.S., many low-income and uninsured, were receiving services last year under the Title X federal program, including STD testing, various screenings, education, and wellness exams. Planned Parenthood and some other providers decided to withdraw from the program rather than comply with what Planned Parenthood calls the Trump administration's "gag order," which bars clinics that participate in Title X from referring women for abortions. The move caused a money crunch for some clinics.
Since then, some of the rejected federal funds have been replenished by state or local funds in Hawaii, Illinois, Maryland, Vermont, Oregon, Washington, Massachusetts, California, and New York. Hawaii's current fiscal year budget sets aside $750,000 to partly cover a $2 million loss in Title X grant money.
In Massachusetts, Republican Gov. Charlie Baker signed a legislation authorizing up to $8 million. In California, the Santa Clara County Board of Supervisors last year voted to cover a $482,000 expected shortfall for six Planned Parenthood clinics serving 36,274 patients. And Pennsylvania's Democratic governor, Tom Wolf, has included a $3 million line item in his proposed 2020-21 budget to also help offset the funding loss for Planned Parenthood providers.
In Oregon, the lead plaintiff in a lawsuit challenging the Trump administration's rule, a spokesman for Planned Parenthood Advocates of Oregon said the agency has been "working closely with state officials to create critical backstops and protect access to care for all Oregonians who need it, regardless of federal action on Title X," and commended Gov. Kate Brown, a Democrat, for prioritizing funding for reproductive health services.
Abortion opponents have accused governors of providing the money to gain favor with an organization that often supports Democrats at election time.
In New Jersey, where Democratic Gov. Phil Murphy last month signed legislation that set aside $9.5 million in state money for family planning at Planned Parenthood, New Jersey Right to Life called it a disgraceful money grab.
"The taxpayers of NJ should not be forced to fund abortion – and make no mistake – that is what this bill will do," Marie Tasy, the group's executive director, said in a written statement.
Title X regulations prohibit funds from being used for abortions, with some narrow exceptions, and the money Mr. Lamont has proposed would fund Title X services and not abortions, according to Connecticut's Department of Public Health.
Abortion opponents in Connecticut have argued for years that state funds should not be used for abortions or abortion referrals.
The state's health insurance program paid for 6,995 abortions in 2018. A Department of Social Services spokesman said Connecticut is under a court order to pay for any abortion for a Medicaid-covered woman that she and her doctor have determined to be necessary.
The state money budgeted by Mr. Lamont would not go toward abortions, as it would fund only Title X services, according to state health officials. But opponents say that regardless of where it goes, the money for Planned Parenthood makes it appear the state is outwardly advocating for abortion.
"I'm disturbed by it, that it's now state policy to outwardly advocate it no matter what," said Chris O'Brien, executive director of Connecticut Right to Life.
It's unclear how long the help from states will continue.
Jacqueline Ayers, vice president of government relations and public policy at Planned Parenthood Federation of America, said it's "encouraging" that governors and state legislators are trying to fill the gap, but said the state-by-state efforts cannot replace the nearly 50-year-old Title X program.
"While we applaud leaders in the states for taking these temporary but critical steps, we must continue fighting for a nationwide solution," Ms. Ayers said. "Only Congress has the power to permanently stop this harmful rule, and people across the country are continuing to call on them to do so."
This story was reported by The Associated Press. AP writers Michael Catalini in Trenton, New Jersey; Marc Levy in Harrisburg, Pennsylvania; Audrey McAvoy in Honolulu; and John O'Connor in Springfield, Illinois contributed to this report.