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Anti-abortion counseling centers, often called “crisis pregnancy centers,” may soon face an existential choice in Minnesota: Leave behind their explicit agenda of dissuading people from having abortions or risk losing state funding.
While some center operators could see that as a nonstarter, state Democrats may leave the door open for them to continue receiving taxpayer dollars — albeit under a battery of rules some Minnesota lawmakers hope could expand services for pregnant people amid the country’s rapidly shifting abortion landscape.
For nearly 20 years, Minnesota’s public funding stream for the centers has flown mostly under the radar. In 2005, then-Gov. Tim Pawlenty, a Republican, signed into law a program to give grants to nonprofits that provide pregnancy and parenting services that do not “encourage or affirmatively counsel a woman to have an abortion.”
By wide margins, the state Legislature approved the Positive Abortion Alternatives statute, pitched by anti-abortion leaders as providing money for prenatal health care and adoption services. The measure even garnered votes from Democrats who supported abortion rights but wanted to fund more services for pregnant people.
The heated political climate since the U.S. Supreme Court overturned Roe v. Wade has put a new spotlight on public funding for anti-abortion centers. At least a dozen states use taxpayer money to fund the centers, and some Democratic-led states have already defunded, or are considering defunding, them altogether.
In 2019, Michigan Gov. Gretchen Whitmer used a line item veto to cancel $700,000 of funding for the chain of Real Alternatives counseling centers in her state, and she has vetoed spending on similar centers in the years since, calling them “fake health centers.” In Pennsylvania, which in the mid-1990s became the first state to provide public money for anti-abortion centers, Democratic members of the House Women’s Health Caucus have called for an end to funding through state and federal Temporary Assistance for Needy Families dollars.
Minnesota Democrats won sweeping victories in the 2022 midterm elections, and control the state House, Senate and governor’s office. They have acted quickly to pass a raft of legislation further protecting abortion in the state, which has become an island of access in the Midwest. The Republican minority can do little to stop them.
As a part of this coordinated effort, Minnesota Gov. Tim Walz has proposed defunding the state’s grant program. But some Democrats support another option.
“I believe that this grant program has a purpose,” said Rep. Liz Olson, a Democrat from Duluth who is sponsoring a bill to change the 2005 Positive Abortion Alternatives statute into a Positive Pregnancies statute. “With changes, I do believe it should be funded.”
Abortion rights supporters say anti-abortion organizations have used state money to establish pseudo-medical facilities to convince or even trick clients into carrying their pregnancies to term, often using medically inaccurate information. Counseling center leaders say that the money has gone towards a variety of services for pregnant people, like parenting classes and free diapers, clothes and cribs.
Minnesota Democrats appear at least willing to hear that argument. Olson and a coalition of reproductive rights advocates supporting her bill are now trying to walk a tricky line: continuing to attack centers’ more misleading tactics while acknowledging that they may offer services that contribute to good birth outcomes for mothers and an array of services for families.
“It never made sense to me that we would take resources away from pregnant and parenting people who need support,” said Megan Peterson, executive director of Gender Justice, a St. Paul-based legal and policy advocacy nonprofit that supports abortion rights and helped craft Olson’s bill. “There’s hospitals that have obstetrics programs closing, especially in rural Minnesota. There’s parts of Minnesota where people have to drive six hours to give birth. We have an issue where CPCs are maybe the only place you can get a free ultrasound.”
Although Walz’s proposed 2023 budget would completely cut funding for the Positive Alternatives Grant Program, which last year distributed about $3.4 million to 27 groups at 33 sites around the state, a spokesperson for the governor said that he would be “open to discussing” Olson’s approach.
Roughly two-thirds of Minnesota’s CPCs do not receive state grant funds, so the majority would be unaffected by the legislation. Some grantees rely on the money for a substantial amount of their operating budgets.
Minnesota, according to the Associated Press, has spent more than $37 million on the grant program since 2010. It ranks fifth in the nation for such spending behind Texas, Pennsylvania, Missouri and Florida.
Efforts to defund anti-abortion counseling centers follow in the wake of a yearslong conservative campaign to defund Planned Parenthood, which has pointed out that its clinics provide a slew of health care services beyond abortion, including maternal care, cancer screenings and contraceptive access.
There are nine abortion providers in Minnesota and an estimated 90 CPCs, many of them in rural areas far from major health care systems. Ashley Underwood, director of Equity Forward, an organization that produces investigative research on gender equity, reproductive health and other issues, said she believes proposals like Olson’s could be a way to convert existing centers into places where pregnant people can go for free health care, minus the agenda.
“People should have access to care that is unbiased and medically sound,” Underwood said. “We absolutely can design a better path forward, and I think that Minnesota is really taking the lead and being an example of how to do that.”
Anti-abortion counseling centers first proliferated in the 1990s and early 2000s; before the end of Roe, one report estimated that nationally they outnumbered abortion clinics 3-to-1. Abortion advocates have accused many of them of a deceitful mimicry: setting up shop close to abortion clinics under remarkably similar names and creating the feel of a medical office by offering services like pregnancy tests and ultrasounds. Some centers are also known to promote the medically unfounded “abortion pill reversal” procedure, or claim abortion is linked to infertility and breast cancer. Free diapers and car seats, detractors said, are just a means to lure in poor pregnant people.
Olson’s Positive Pregnancies Support Act would maintain the centers’ eligibility for public money, so long as they agreed to provide “evidence-based, accurate information” and “ensure that none of the money provided is used to encourage or counsel a person toward one birth outcome over another.”
The measure would allow organizations that provide abortions and affirmative abortion counseling to apply for grants to provide services to pregnant people and new parents. It would require that services such as ultrasounds be provided and interpreted by a licensed medical professional. It stipulates that food, clothing, housing assistance or similar services be provided in a manner that is not predicated on an agreement to view an ultrasound or enroll in certain classes or counseling. And it further shores up privacy protections for clients.
Crucially, it requires that grantees provide referrals for an abortion on request. At a House health policy and finance committee meeting on the bill in January, leaders of groups that currently receive state funds testified that this would be in direct opposition to their mission.
“If we are forced to provide referrals for abortion, we will no longer be able to receive this grant,” said Jill King, executive director of Lakes Life Care Center in Forest Lake, who testified that state grant money makes up 40% of her budget. “A woman who wants an abortion does not need a referral from us. She already knows where to go. If she comes to us, she’s looking for a different option.”
Julie Desautels, treasurer for Life Connections in Alexandria, said in an interview that while she is skeptical about the intent of the proposal, her board of directors may be open to applying for the grant.
Desautels said her organization — while founded on “pro-life” principles — is not religiously or politically affiliated and makes clear to its clients that it is not a medical facility; there is no abortion clinic in Alexandria. She said most of her clients are low-income, minority and LGBTQ pregnant people and parents living in a relatively rural part of the state. Life Connections hosts a support group with free childcare called MomTalk; Desautels said it has paid clients’ rent and utilities, and distributed thousands of dollars in gas cards, as well as cribs and car seats. She said it was so well-stocked with formula that it saw clients through the 2022 shortage.
“We had women in our lobby crying because they went from store to store and could not find formula,” Desautels said. “I would say it averages about one person a week that we help ward off eviction or get their utilities turned back on. I’ve got two right now on my table I have to send checks out to.”
Olson said that her biggest hope for the law is not that it keeps existing counseling centers in business, but that it expands the pool of eligible organizations and creates more centers that provide free services around birth — whether they provide abortion services or not. Part of that hope came from her own personal experience.
In 2015, as she neared her due date with her first child, Olson learned from her midwife that her blood pressure was unusually high, a possible symptom of preeclampsia. When she couldn’t get an appointment for an ultrasound to make sure the baby was alright, her midwife mentioned that one option would be to visit a crisis pregnancy center.
Olson decided to wait for an appointment at the hospital and, days later, gave birth to a healthy baby girl. But the experience stuck with her. She imagined what it would mean for pregnant people with no money and no insurance to walk in off the street and be given free prenatal health care. It frustrated her that only facilities with an anti-abortion agenda were getting state money to do such a thing.
“There’s so much wrong with how we do pregnancy and delivery and postnatal care in our country,” she said. “The context, for me, is less about the CPCs and more about expanding access to care through this grant program to make sure that people are getting these types of services in a medically accurate way with trained professionals.”