Cecile Richards: The TT Interview

As the daughter of late Democratic Gov. Ann Richards, Cecile Richards always knew what adversity looked like. As the president of the Planned Parenthood Federation of America, she’s in the thick of it now.

Richards has had tough jobs before — founder of the Texas Freedom Network, president of America Votes, deputy chief of staff for Democratic U.S. Rep. Nancy Pelosi. In her current post, she finds her New York-based organization effectively under siege, both in the U.S. Congress and the Texas Legislature. In an interview with The Texas Tribune, Richards discusses Republican lawmakers’ efforts to defund Planned Parenthood, a Texas attorney general’s opinion she says will keep low-income women from preventative care, and how her mother would’ve handled all of this. The full transcript is below.   

TT: With the anticipated passage of abortion sonogram legislation, Texas is poised to have some of the toughest abortion laws in the country. Does Planned Parenthood ever feel like throwing in the towel here?

Richards: No way. It’s certainly a good question. But we are such an enormous provider of health care in the state of Texas. And we just continue to forge ahead. Texas definitely has a lot of restrictive laws, as do other states. But women continue to come to Planned Parenthood regardless of the politics of the state, regardless of the laws, because they need health care. I’m really proud that, in the state of Texas, despite everything, we have 81 health centers and see more than a million women and men every year for health services. We’ll be there for eternity, as far as I’m concerned.

TT: Obviously, the abortion sonogram bill is making big headlines here. But what may be even more debilitating for Planned Parenthood is an attorney general’s opinion that effectively gives the state the go-ahead to boot your organization from the Medicaid Women’s Health Program. Do you all intend to put up a legal challenge?

Richards: We’re looking at it, and following this very closely. The irony of that kind of legislation, or in this case, an opinion, is all it would do is really dismantle the ability of women in Texas to get family planning services, basic reproductive health care, at a time in which the unintended pregnancy rate in Texas is so high. This would be devastating for women. We’ll do whatever we need to do to ensure women in Texas can get access to family planning. It’s a political move, and it’s shortsighted. It’s one of the worst things you can do in terms of the Women’s Health Program. In 2009, we saw 263,000 clients in Texas. More than 200,000 of them were for family planning, for birth control. We do an increasing amount of STD testing and treatment. In Texas, we performed 382,000 [STD] tests that year. It’s such a growing and important area of health care. And then of course, as you know, for many women who come to us for family planning, they also get their breast exam, their Pap smear. We did 140,000 breast exams for Texas women [that year]. For many women who are young or don’t have insurance, who don’t have a doctor they regularly go to, a family planning center like Planned Parenthood is likely the only health care they’ll get all year. We’re able to set them on a pathway for other health care needs. Because of efforts in the U.S. House, in Texas, to roll back women’s health care access at Planned Parenthood, we’ve heard from so many thousands of women who say Planned Parenthood was the place they first got birth control, the place they found out they had early stage cervical cancer. They may have come in for birth control, and found out they had a lump, or an early stage irregular Pap, and went on to get treatment.

TT: What you haven’t talked about yet is the abortion services Planned Parenthood provides. What do those numbers look like?

Richards: In 2009, Planned Parenthood provided 22,560 abortions in Texas. If you want that stat in context, in 2007, Planned Parenthood provided 24.6 percent of the 80,886 [abortions in Texas that year]. We see 3 million patients each year across the country. For 97 percent of them, we provide preventive care. Three percent are abortions. That pretty much holds true from state to state. What is obviously nonsensical is, the best way to prevent an abortion or the need for an abortion is to prevent unwanted pregnancies. We share a common goal: to help women get family planning services, to reduce unintended pregnancies and to reduce the need for abortion. To eliminate the nation’s largest family planning provider would be the worst thing you could do.

TT: Clearly, you’re not just under pressure in Texas. In Washington, GOP leaders are also working to cut off the flow of funding for your services. If you lose funding at the state and federal level, does Planned Parenthood have the revenue to stay in operation?

Richards: We will continue, we’ll continue. But what would be so devastating about what’s being proposed by the House leadership is that low-income women, people who come to Planned Parenthood because it’s a quality provider of health care at affordable rates, or because they qualify through a federal program, are not going to have anywhere to go. I’m not sure the House leadership has fully thought through those implications. We see 3 million patients a year, and 2 million qualify for some type of federal assistance. About 74 percent of our patients are at 150 percent of poverty or below. In a lot of parts of the country, we are it — in rural areas or medically underserved areas. For so many places in the country, if there isn’t a Planned Parenthood provider, there isn’t any provider. For many, many women who are on Medicaid, it is not easy to find services. In Texas, through the [Medicaid] program there, Planned Parenthood provides 41 percent of the family planning that’s provided through the Women’s Health Program. The other irony about all of this is, we at Planned Parenthood are reimbursed at a lower rate than other providers, and we’re still competitive. We compete with others, and that’s why the federal government contracts with us, because we provide high quality services that are very cost effective.

TT: What kind of role did your mother play in propelling you into this line of work — and do you find yourself channeling her in any of these firefights?

Richards: I wish I could channel her. People are always saying, "What would your mother say?" That’s the hardest one. Mom was a Texan through and through. She grew up outside of Waco, went to Baylor, she really lived her entire life in Texas. And she knew these struggles that women face. One of the fundamental struggles women face in Texas and around the country is getting access to basic health care. She felt so strongly about women advancing, so very strongly about women’s rights. I think she always taught all of us to stand up and fight for what is right. Whether I’m channeling her, or carrying on the work she’d want us to be doing, these are issues she believed in. She just believed in women and the importance of women standing up for themselves. It’s an honor for me to work with Planned Parenthood, an organization that for 95 years has provided vital health care for millions of women, and now men. That’s an incredible legacy.