Throughout his campaign, President-elect Donald Trump made promises to make drastic changes to domestic and foreign policy, including a reproductive rights overhaul, immigration reform, and rolling back federal protections for transgender individuals.
In California, state-wide policies ensure access to health care and guarantee civil rights to residents, regardless of immigration status or gender identity.
However, national law is supreme over state law, as outlined by the Supremacy Clause of the U.S. Constitution.
Christian Garcia, Vice President of Communications for Planned Parenthood Northern California, spoke with NSPR about potential challenges and changes for reproductive health care in Northern California under the incoming administration.
Recent challenges for rural health clinics
Planned Parenthood Northern California is a regional affiliate serving 20 counties that span from San Francisco all the way up to the Oregon border. It operates 17 health centers that serve a high number of rural patients, including locations in Chico and Redding. Patients in these areas already face a number of challenges accessing care. Garcia said the Chico clinic in particular is seeing an uptick in onsite protesters.
“They're bringing amplified noise, whether those are microphones with speakers or megaphones, and they're just creating a ruckus outside,” Garcia said. “So one of the efforts that we've been doing is working with law enforcement to identify more protections that we can put in place.”
The clinics have also seen an increase in out-of-state patients and telehealth visits. Garcia said the influx of out-of-state patients is the result of restrictive abortion policies in neighboring states. Rural patients benefit from access to telehealth appointments, which save time and money for patients who live hours away from a reproductive health care clinic.
“The last thing that we're experiencing in the rural communities is more community-based hospitals are going out of business,” Garcia said. “You have entities like St. Joseph's and other Catholic entities that do not provide reproductive health care services and abortion care, and so we are the only provider in a lot of these communities.”
St. Joseph Hospital in Eureka, for example, denied a woman an abortion in February, even though the pregnancy was no longer viable and the mother’s life was in danger.
Funding complications under a Trump Administration
Garcia said the agency expects to face even more challenges under the Trump administration, including to its funding.
In 2019, then-President Trump began to enforce the gag rule. The gag rule forbids organizations that receive federal funding from referring patients to get an abortion.
President Biden rolled back the gag rule when he took office and issued several executive orders to protect reproductive choice after the reversal of Roe v. Wade. Experts predict these protections will be immediately suspended when President-elect Trump takes office, and the gag rule to be reinforced.
In that case, every public health entity in California, and across the country, would be at risk of losing funding if abortion care is part of their referral practice.
Similarly, President-elect Trump could issue an order to specifically defund Planned Parenthood.
Defunding Planned Parenthood would strip the organization of around 40% of their annual budget, forcing it to make reductions across the board. Reduced care would have the greatest impact on people who have no other place to go for health care services.
Garcia shared current statistics about what kinds of services are provided to patients in the North State. He said about 17% of care is related to contraception and only between 3-7% is related to abortion care. The majority of patient services are related to testing and treatment for reproductive illnesses.
Planned Parenthood also provides breast cancer examinations, behavioral health services, and family planning counseling. If its funding is cut, the capacity of rural clinics to provide these essential services would be severely impacted and many North State residents could have nowhere else to go.
“The other thing is if there are cuts to Medicare, which we know has been talked about, that really impacts our patients, because 85% of our patients are Medi-Cal recipients,” Garcia said.
Planned Parenthood taking precautionary measures
In anticipation of these challenges, Garcia said that Planned Parenthood Northern California has taken precautionary steps to protect abortion access across the state. One of those efforts is called the SAFE Campaign, which stands for Secure Abortion Freedom Access.
SAFE was a $5.5 million campaign that expanded the regional affiliate’s footprint across the North State by hiring additional clinicians and improving patient navigation. It also helps pay for uncompensated care to reduce clinics’ financial burden.
Proposition 1 is another state-wide measure that was taken to protect women’s right to reproductive health care. It is an amendment to California’s constitution that was approved by 67% of voters in 2022. National law trumps state law, however, so federal regulations that restrict abortion access would cancel out the protections offered by Prop. 1.
“One of the things that we have been doing in preparation for that is continuing to work with the legislature, with Governor Newsom and his administration, [and] our allies with the Future of Abortion Council, to figure out what we can proactively do here in California,” Garcia said.
As the time nears for President-elect Trump to take office, community support will become increasingly important. Garcia encouraged North State residents, and men in particular, to join the fight to protect reproductive health care.
“In the 108 years that Planned Parenthood has been around, we have always been a target. We have always been under attack, and we have continued to survive, and we have continued to provide services to our patients,” Garcia said. “In the next four years, it's going to be no different. We will continue to do everything we can to be operational and to ensure that our patients have the care like they need.”
