Pregnant and scared? Then stay out of Missouri, which hands welfare money to dubious anti-abortion centers

In 2012, Tara was sexually assaulted by her husband at their home in the St. Louis area. A month later, she suspected she might be pregnant. Tara (not her real name) was 26 years old, traumatized by her abusive husband (from whom she was now separated) and unsure what to do next. She had grown up in mid-Missouri and remembered driving past some kind of pregnancy resource center on Providence Road, in Columbia. She looked up the place — My Life Clinic — and called to ask if someone there could recommend a similar center in the St. Louis area.

Though Tara did not know it at the time, she ended up at what’s called a crisis pregnancy center. This CPC administered a pregnancy test and a limited ultrasound — the kind during which the device is placed on the outside of the stomach rather than being inserted transvaginally. She walked out with some pamphlets, which she recalls containing Christian undertones about “life.” 

“They told me I was roughly 11 weeks pregnant,” Tara says. “They were very positive about everything: ‘Congratulations on your baby.’ They kept saying the word ‘baby.’ Never ‘pregnancy.’ And when I finally asked about an abortion, they just kept on talking like I hadn’t said it.” 

Tara was certain she could not have been 11 weeks pregnant. So she sought a second opinion through Planned Parenthood. 

“I received a transvaginal ultrasound, where they showed me the follicle, the egg, everything,” she says. “They went through item by item and gave me the full range of what my pregnancy options were, moving forward. It was a real medical exam.” 

Planned Parenthood’s more rigorous medical evaluation also revealed that Tara was, in fact, only five weeks pregnant. 

“A six-week difference is a very big deal when you’re in that situation,” Tara says. “It [the CPC] caused me a lot of undue and unnecessary stress at a really difficult time. I don’t know if that’s typical, but if it is, it’s shameful.” 

There are about 60 CPCs spread across Missouri. You have likely seen their billboards, the ones that appear: “Pregnant and scared? Call us.” Their marketing often suggests they offer full-service reproductive options for pregnant women, but none are licensed to provide abortions. (There is, in fact, only one remaining abortion clinic in the state of Missouri, and it’s in St. Louis.)

According to a 2012 report by the NARAL chapter of Missouri, almost none of the CPCs in the state employ doctors or nurses on staff. NARAL’s investigation was unable to find a single center in Missouri willing to refer a woman seeking an abortion to an abortion provider, and the vast majority (92 percent) of CPCs refused to tell women where they could obtain birth control. CPCs “discourage abortion, discourage birth control, and promote non-marital abstinence and explicitly Christian beliefs,” the NARAL report concludes. 

For women like Tara, CPCs — which are unregulated by the state — are a misleading and sometimes dangerous waste of time. But instead of monitoring them, Republicans in Missouri have passed a law to send money their way — money that by any reasonable interpretation of federal law should be going to helping the state’s poverty-stricken families. 

In the old days, before President Bill Clinton and a Republican-led Congress passed welfare reform, in 1996, the federal government administered welfare assistance in America. One of the outcomes of the new law was to give states the power to decide how to distribute welfare money. For the past two decades, states have received an annual block grant from the federal government — it’s called Temporary Assistance for Needy Families, or TANF — and then decided how to spend it. 

During the 2015 session, Republicans in the Missouri Legislature overrode Gov. Jay Nixon’s veto to pass SB 24, which modified the state’s TANF laws. Before, an individual was eligible for 60 months of TANF benefits in a lifetime. Republicans slashed that number to 45 months. Because federal law guarantees 60 months of assistance, this is money for needy families that Missouri is essentially leaving on the table — not unlike Missouri Republicans’ cruel decision not to expand Medicaid in the state. (The change from 60 to 45 months also required administrative adjustments costing in excess of $400,000, according to state budgetary information.) 

This move, which went into effect last January, has already had devastating effects on Missouri’s poor. In November 2015, TANF checks — which average $224 per month and max out at $292 per month, an amount unchanged since 1991 — were distributed to just shy of 25,000 families. As of November 2016, there were 14,000 families in the state receiving TANF cash assistance. 

“That’s 11,000 needy families, including about 19,000 kids, all cut off in just one year,” says Jeanette Mott-Oxford, a former Missouri state rep who now heads Empower Missouri, an anti-poverty organization. 

This might not be quite so egregious if Missourians were living comfortably. They are not. One in seven Missourians lives below the poverty line. One in five Missouri children lives in a food-insecure household. 

“There are six counties in our state where over 40 percent of the children live in poverty,” Mott-Oxford says. “These people have enormous challenges, and they’re being asked by our legislators to do the impossible with the inadequate. And then when they can’t, they’re punished by these policies.” 

Rep. David Sater, who represents Cassville in the Legislature, introduced SB 24. He did not respond to a request for comment. In Barry County, which Sater represents, 20 percent of the residents live below the poverty line. 

States can’t use their TANF money on just anything. Spending must meet one of four requirements. One is to “provide assistance to needy families,” i.e., temporary cash payments for people in need. The three other requirements are less direct, and more tangential to what we traditionally think of as welfare. They also have something of a family-values flavor to them, reflecting the views of the Newt Gingrich-led Congress of the time: “end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage”; “prevent and reduce the incidence of out-of-wedlock pregnancies”; and “encourage the formation and maintenance of two-parent families.”

As the Center for Budget and Policy Priorities notes in a report issued last year, “Since the four TANF goals are extremely general, states can use TANF funds much more broadly than the core welfare reform areas of providing a safety net and connecting families to work; some states use a substantial share of funding for these other services and programs.”

Missouri is one such state. In 2015, Missouri spent roughly $420 million in TANF funds. According to the CBPP, only $77 million went to actual cash assistance for needy families. Just $148 million — about a third of the money — went to what are called core welfare activities: cash assistance, child care, work programs. The other two-thirds (about $270 million) went to fund “other services,” meaning anything Missouri lawmakers could argue fell under one of the other three TANF goals. 

A quieter provision in SB 24 requires that 2 percent of all TANF funds go to “alternatives to abortion services,” or A2A, in Missouri. The A2A program funds CPCs like the one Tara went to in 2012. One might assume CPCs — which, again, discourage abortions and the use of birth control — would not be a natural recipient for a program that seeks to “reduce the incidence of out-of-wedlock pregnancies.” One might even conclude that CPCs often achieve the opposite of reducing out-of-wedlock pregnancies. But Missouri Republicans don’t see it that way. Under SB 24, they awarded $4.3 million in TANF money to CPCs last year. (In total, Missouri CPCs got more than $6 million from taxpayers, if you include direct funding from the state budget.) 

Though other states use TANF money for questionable purposes — a glaring example exists in Michigan, where the state has come under fire for allocating TANF for college tuition; in one case, a family making $200,000 a year received TANF benefits to send their daughter to a private college — Missouri is one of only seven states that uses the money for anti-abortion services, according to recent data collected by ThinkProgress. 

As a physical therapist, Deb Lavender, a Democratic House rep in St. Louis, says she’s particularly troubled by the lack of medical rigor at CPCs. She has filed a bill, HB 236, that would require all organizations that provide pregnancy-related services to give “medically accurate and unbiased information” to those who walk through their doors. 

“I don’t have a problem if they [CPCs] don’t want to provide that kind of [abortion] counseling,” Lavender says. “But they need to be upfront about the fact that they don’t provide that service. I’ve heard from women in my district who went to these places, and it took them two weeks of appointments before they realized that they weren’t going to be able to get an abortion there. I don’t think we should be giving state and federal tax dollars to places that mislead women that way.”  

Lavender says she’s hopeful that her Republican colleagues who oppose abortion will at least agree about the importance of providing reliable medical information to women. Meanwhile, Republican lawmakers have already filed at least 14 bills seeking to restrict abortion access in Missouri, and the U.S. Congress is closer than ever to completely defunding Planned Parenthood. 

As for Tara: She ended up having her child. He’s now 3 years old. 

“He’s the best thing that ever happened to me,” she says. “But I wouldn’t have kept him unless I’d gotten legitimate, medically accurate OBGYN care, which is the opposite of what I got [at the CPC]. And I still go to Planned Parenthood for my yearly exam. I want my insurance company to pay them.” 

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