Q&A: Planned Parenthood Affiliates of California CEO Jodi Hicks

With drastic federal spending cuts being imposed on Medicaid patients, we sat down with Planned Parenthood Affiliates of California CEO Jodi Hicks to assess the impact of those cuts on her organization and the significant number of California women and men who rely on PPCA for much of their health care.

CW: What is the lay of the land currently with Planned Parenthood in California?
Hicks: We’re several years post Roe v. Wade being overturned, and I think we’re still witnessing what will happen and when we don’t have that Supreme Court protection, with the latest being H.R.1. That bill has a provision that completely defunds Planned Parenthood. So rather than saying ‘we won’t pay for abortion services,’ which they already don’t do at the federal level, they described an entity that is exactly Planned Parenthood and said ‘we won’t pay for any of those services that Planned Parenthood provides.’ So it disproportionately impacts California because in California we have made such efforts to invest in and expand the services that we provide in Medicaid. I think there’s 109 Planned Parenthood centers right now throughout the state of California, and about 80 percent of our patients are Medicaid patients. So when they aren’t paying that federal portion, it is about $300 and some million that is lost just in Planned Parenthood, not including the other Medicaid cuts included in H.R.1. And that’s not sustainable. It was an attempt to close down clinics. It’s an attempt to stop Planned Parenthood from doing all of the work that they do because our mission is to continue to provide abortion. And so, here in California, we have to advocate with our state how we’re going to be able to stay open and continue to provide those services because the footprint is so large here in California and so important to patients. We have over a million visits a year. One in four women depend on being able to have a Planned Parenthood health center open when they need that sometime in their lifetime.

CW: Have clinics been closing?
Hicks: Yeah, it was like kind of South Bay into the Central Valley area. I can get you the five locations. (NOTE: The five Northern California PP clinics closed due to federal budget cuts are in South San Francisco, San Mateo, Gilroy, Santa Cruz, and Madera.) All Planned Parenthood health centers are absolutely at the margins. When you take away that many Medicaid patients, the margins are very thin on what you can do and what you can shift in the services you provide. We are working diligently with the state to see how we can ensure that the state is coming in and that health centers stay open. This was a one year provision in H.R.1, so we’ll see what happens next year. But what we know is it’s not sustainable at the congressional level that they continue to put what is essentially economic sanctions on a state like California for ensuring that reproductive health care is available for this many patients here in California.

CW: Obviously when you say Planned Parenthood, people think about abortion services. Detail some of the other health care services that Planned Parenthood provides to women that are well apart from just pregnancy control.
Hicks: There’s many, many places where Planned Parenthood is the trusted provider, and so they may have found their way into our health center because they needed birth control, but they continue to come back because they need preventive care, they need a mammogram, or they need their pap smear, all of the services that we provide. I think the irony of this is they’re going after the plethora of services that people have come to depend on as Planned Parenthood continues to be a very trusted health care provider for many, many women. And not just women. We service men as well in the health centers, but we are talking about cancer screenings, STI screenings, birth control, absolutely, but oftentimes primary care and prenatal care as well. And so all of those services will no longer be receiving federal dollars for anything basically that Planned Parenthood provides.

CW: And how soon does that go into effect? Is that already in effect or is there, because that was an emergency clause in that H.R.1?
Hicks: That all went into effect day one. There are lawsuits in place, so we’re definitely fighting back with every tool that we have. But, that’s just the economic way they’re using to try to restrict access to reproductive health care. There are definitely other policies we are bracing for, like attacks on medication abortion and attacks on gender affirming care. Essentially all the ways that despite all of the safeguards and everything California and our legislature and our governor have done to ensure that we value reproductive health care here in California.

CW:  Do you have an idea how many or what percentage of the clinics are in what would be considered rural areas?
Hicks: I think it’s safe to say that because somewhere around 80 percent of our patients are on Medicaid, whether it’s urban or rural, we’re definitely located in those areas where there’s the most vulnerable populations and they are in those areas purposefully where the need is greatest.

CW: How much care for the LGBTQ+ community, such as gender affirming care, does Planned Parenthood provide?
HICKS: Certainly for the LGBTQ community, it’s such an important health center because it is trusted and they feel safe. People come to Planned Parenthood because they are entrusting those health centers with some of their most private decisions, and so it makes sense that they continue to come back for their other health care needs. It’s why we have such an important footprint throughout the state of California. The California Primary Care Association signed on to a letter to Congress during the time that H.R.1 was going through the process to make clear that they don’t have the capacity to pick up what would be the loss if Planned Parenthood health centers were to go away because our footprint is so large.

CW: You went where I was going next, which is where all these people are supposed to go. We know that for illness they can still go to emergency rooms and not be turned away, but that is the worst way for anybody to get health care. So where are the folks who you normally take care of supposed to go if they can’t go to a place like yours?
Hicks: That’s a question I don’t want to have to answer. I mean, you can look at other states and the health outcomes for women, for the maternal health outcomes, for birth rate, all of those things. You can look at the data on any state that bans abortion or has taken steps to defund Planned Parenthood or take away people’s access to reproductive health care. And the health outcomes are astronomically bad. And it’s certainly not something for California that we can withstand, nor do we want to. It’s against all of our values here in California. I think everybody’s working really hard to ensure that Planned Parenthood stays open.

I call it developing that voting muscle for reproductive rights. We haven’t had to do it in the past. And now reproductive rights depend on every single election. There’s no backstop anymore with the Supreme Court.

CW: I can only presume how stressful this has probably been for you. How do you take care of yourself in a situation like this? How are you managing to take care of your own mental health and maybe physical health and all of this maelstrom?
Hicks: First of all, I have an amazing team. Planned Parenthood has amazing people that continue to fight for all of these issues every day. Whether it’s the affiliates and the people that come to work every day at the health centers or people that work for our advocacy team, They’re just tremendous. And I’m not crazy enough to think that all of this lies on my shoulders. It’s this entire team that does this work every day. So I remain eternally grateful for everyone that shows up and continues to fight for all of the fights that we have right now.
CW: How has the messaging for Planned Parenthood evolved over the last few years? How has what has been going on impacted how you message to the public?

Hicks: What I have witnessed in the evolution of people’s awareness and what people want to talk about is that since Roe v. Wade has been struck down, people want to fight for abortion rights and they want to fight for their ability to receive reproductive health care. And I think that when those rights were taken away for half the country, we definitely saw a shift in how people wanted to talk about it. They want to be very direct about what they were fighting for. And so we do that. Planned Parenthood was defunded not because we’re these clinics that provide birth control. We’re defunded because we provide abortion services. And they gave a deadline. If anyone wanted to stop providing abortion services, they could go back to being funded. So it’s very clear on one side what they’re attacking, and I think we’re very clear in what we’re standing up for right now is the people’s ability to be able to make decisions that affect their lives and their livelihood. And I think people understand that, and they definitely want that. And so we trust in that and we continue to be a very trusted messenger for Californians, and we lean into that.

CW: Do you find most people understand how California is different from the rest of the country?
Hicks: Yes. If Californians have a chance to vote directly on safeguarding reproductive health and reproductive freedoms here, they overwhelmingly will vote to do that. What does become a little more difficult is an understanding that despite 67 percent of Californians voting to ensure that that right is enshrined in our California constitution, that at the national level they could still ban abortion and it would affect California. They can still do something like H.R.1, which is do economic sanctions that affect whether or not Planned Parenthood can stay open here in California. So that messaging has been harder. And honestly, it makes sense because, again, we had almost 50 years of Roe v. Wade where people felt and lived under that cloak of federal protection. And here in California we’ve had such strong laws to protect reproductive rights, it’s a little bit of a slow understanding that something like it being overturned could still happen. I call it developing that voting muscle for reproductive rights. We haven’t had to do it in the past. And now reproductive rights depend on every single election. There’s no backstop anymore with the Supreme Court.

CW:  Do you feel like the younger generations understand now what is at risk?
Hicks: What I find really, really outstanding is when you look at the data of young people, it’s not the percentage of how many come out and vote. It’s how they’re voting when they come out and vote. And they are absolutely voting as a bloc. And I don’t think we’re honestly appreciating that all demographics don’t have such a huge bloc that actually shows up. I think every demographic has issues on whether or not they come vote. Even if it’s raining. People don’t want to fight a storm to show up and vote. That’s very clear. But when young people come out to vote, they’re all voting and standing up for rights and they’re voting in a bloc that I think is really important. And so we have to nurture that and appreciate that and I think recognize it.

CW: What do you see as the biggest challenge maybe in the next year? And maybe the biggest opportunity? Is there anything positive that you can point to that will give people a little hope?
Hicks: I think the challenges are huge and almost existential. I think we understand that our rights depend on elections right now, that we’re not depending on the courts. And yet, there’s so much happening, like just the ability to be able to vote and to hold a fair election. And so, where we would normally want to be messaging influencing Californians, we now have to work on these other structural issues. And those are challenges that are hard to wrap your mind around. But given those challenges, people are still working really, really hard and are willing to fight back in a really strong way. And when I talk about Roe v. Wade and us having those almost 50 years of protections, we also were complacent about that. Roe v. Wade was always supposed to be the floor, not the ceiling of what we fought for when it comes to reproductive rights and reproductive health care. And I always remind folks that the state law that ended up going to the U.S. Supreme Court was in Mississippi. And there was actually only one clinic in the entire state. And so we’re fighting over a state that actually didn’t even have access to reproductive health. And so I do think there is a lot of opportunity as we continue to fight for reproductive rights and what that will look like down the line to message that we’re also fighting for reproductive health care. We’re also fighting for people to not access to a provider, but about equity in health care and ensuring that we’re making the right investment so that everybody has an opportunity to make decisions that affect the rest of their lives. So I think there’s lots of opportunity to have those conversations and shape the future moving forward.