What's happening in New Hampshire is indicative of just how precarious abortion access remains throughout the country.
New Hampshire is a state that is generally supportive of abortion rights, with relatively few restrictions on the procedure. However, recent events in the state show how fragile access to reproductive health care can be, as Republicans are prepared to hold family planning funds hostage in their zeal to restrict abortion.
New Hampshire has a family planning program that is designed to ensure people have access to reproductive health services and to help people "determine if and when to have children, and to prevent unintended pregnancy." Those services are available to everyone in clinics across the state.
State funding for the program flows through the state's Executive Council, an elected body with five members that approves or rejects all state contracts, including providers like Planned Parenthood.
Those contracts were routinely approved for nearly 40 years until a decade ago, when anti-abortion politicians attained a majority on the Executive Council. This year, the state's budget bill added an audit provision that will likely significantly delay funding to entities that perform abortions.
The contracts for Planned Parenthood and other clinics that provide family planning and abortion services all expired on June 30, the end of the state's fiscal year. In past years, if the contracts weren't executed by June 30, the Executive Council would approve a retroactive funding contract to cover any gap in care.
This year, the audit provision throws a wrench into that funding scheme and a gap in care is all but assured. Though New Hampshire already prohibits the use of federal or state funds for abortions, the new provision requires the state's Department of Health and Human Services to audit every family planning provider yearly to ensure they don't use funds for abortions.
Republicans on the Executive Council assert that by performing abortions at all, Planned Parenthood is using state funds for those abortions, even though the state funds are used for other things. Planned Parenthood has consistently maintained it doesn't use state funds for abortion care, and no one has put forth any evidence that it does.
The audit provision almost certainly guarantees that there will be a gap in family planning funding to places like Planned Parenthood. The audits are not anticipated to be complete before the end of the year, and the law contains no explanation of how the audits are to be conducted. The state health department has indicated that all family planning services, such as breast cancer screenings and pap smears, would be delayed until the financial review is complete.
The law does not explicitly state that the Executive Council must wait to approve contracts until after the audits are done, but at least one Republican on the council, David Wheeler, has stated he will not vote to approve until then. Wheeler also insists that the audits could be done in a month, disregarding information from the health department that it will take much longer.
Earlier this year, Republicans in the New Hampshire state House attempted to force family planning clinics to physically separate their facilities into one facility that performed abortions and another that provides all other services. Conservatives made the same argument there that they're making here: Clinics like Planned Parenthood are secretly commingling their funds, and therefore state money is going toward abortions.
What's happening in New Hampshire is indicative of just how precarious abortion access remains, even in states that are not notably hostile to the procedure. Until this most recent budget bill, the state had never passed an abortion ban of any sort, but the bill included a ban on abortion later in pregnancy. Though the state's Republican Governor, Chris Sununu, continues to say he is "pro-choice," he signed off on both the ban and the audit procedure.
The battle over audits and contracts also highlights that anti-abortion politicians are willing to hold basic health care needs, such as cancer screenings, hostage as leverage to force their anti-choice legislation. As the country faces what the Guttmacher Institute, which tracks reproductive health legislature, calls the worst year ever for abortion rights, you can expect to see more use of pressure points like this.