Mary Alice Carter, Senior Advisor | December 18, 2020 Blog Post

We’ve all seen the billboards on the highway and the bus and subway ads. The text reads, “Pregnant? Afraid? We’re here to help.” And they often feature a woman, usually white, with her head bowed, brow furrowed. Underneath is a toll-free number and a website link. If you have ever thought that these numbers or websites directed you to a health center that provides abortions or at least would support that option, you’re not alone in making that mistake. In fact, the ad was designed to ensure you make that mistake.

These ads are for anti-abortion centers (AACs), and the intent is to ensure that people who are seeking abortions enter their locations instead of an actual medical clinic that provides abortion. Instead of providing people with the non-judgmental health care they need, AACs have one goal: to convince and coerce people away from their abortion decisions. And tens of thousands of them operate across the nation, many on taxpayer dollars. 

Deception Is the Entire Point

Don’t take just my word for it. At a conference for these centers, anti-abortion provocateur Abby Johnson revealed AACs’ deceptive strategy: "We want to appear neutral on the outside. The best call, the best client you ever get is one that thinks they're walking into an abortion clinic. Those are the best clients that could ever walk in your door or call your center, the ones that think you provide abortions."

These centers use elaborately devised tactics to trick people into believing they provide abortion services. From the names they choose, which often vary only slightly from those of abortion providers, to their locations, often next to or across the street from a legitimate center, to their websites, where they list “abortion” in multiple places. If you dig deep enough, sometimes you can find a disclaimer in the footer that lays out that they do not actually provide these services.

Take this site for the Women’s Care Center, a deceptively named taxpayer-funded AAC in Indiana. Looking at the webpage (screenshot below), compare where you can find the disclaimer information — at the bottom of the page and in a minimally sized font — and the header that talks about abortion. Anybody would be very confused about what services they offer.

[Accessed December 15, 2020]

[Accessed December 15, 2020]

Deception With Tax Dollars

It is abundantly clear that AACs are deceptive in their practices, so it comes as no surprise that Equity Forward has tracked areas of deception in their finances as well. AACs run unchecked, minimally monitored and yet funded with millions in several dozen states, including funding from federal Temporary Assistance for Needy Families (TANF) dollars. Equity Forward has investigated and reviewed hundreds of pages of documents that detail the lack of scrutiny of what happens with these funds once they leave state coffers and reveal how wasteful the operations are. Yet time and time again, conservative lawmakers fund these programs, all the while simultaneously championing cuts to social service programs that actually help people.

A particularly poignant example of this waste is Real Alternatives, Inc, a 99% taxpayer-funded entity headquartered in Pennsylvania that runs programs in that state as well as Indiana. It previously ran a program in Michigan, but after it was found to have violated its contract and not provided the services it claimed it would, Governor Gretchen Whitmer rescinded its funding. A previous Republican governor had also attempted to defund the program due to poor performance but was overruled by conservative legislators.

We found that Real Alternatives took more than $800,000 from state funds meant for services for low-income people and redirected it to expand its operations in other states. As a result of this expansion, the executives at Real Alternatives have seen their salaries balloon to more than $700,000 each year for just three people — with CEO Kevin Bagatta making more than $300,000 each year. In comparison, a family of three in Pennsylvania is ineligible for TANF if they make more than $403 each month (or $4,836 per year). In addition, while touting their support with “diapers and clothing” for new parents, material assistance is capped at $24 per client. Something is incredibly unbalanced with the way this organization prioritizes who receives this state funding.

The outrageous lack of oversight and mismanagement for this type of taxpayer-funded “Alternatives to Abortion” program is not restricted to Pennsylvania. In fact, it is characteristic of programs in state after state. Many of these states, including Florida, Texas and Arizona, have consulted directly with Real Alternatives.

In Florida, this permanent taxpayer-funded program’s AACs often employ medically inaccurate, religious and coercive tactics for people seeking health care. Yet the state Health Department relies largely on “self-monitoring” to ensure centers are complying with the program’s agreement.

In Texas, an Alternatives to Abortion program that Real Alternatives proudly boasts is modeled on their own shady operations gets almost $60 million in a no-bid contract process. Some of these funds are TANF dollars.

Arizona has attempted to fund another Alternatives to Abortion program, with legislators claiming they would like to model it on the Human Coalition program in Texas and North Carolina — where hundreds of thousands of dollars have been squandered on religious materials.

And to top this all off, federal family planning funds, known as Title X funds, have been redirected under the Trump-Pence administration to the national AAC network Obria. Obria is an organization that not only is opposed to birth control but also administers an unsafe and unapproved regiment that claims to stop a medication abortion.

Anti-abortion center programs are a disaster for not only public health but also fiscal health. At the very least, they should face more oversight, be held accountable for their violations and be held to standards for medical practice — and lose funding when they break the law. Based on the facts, they really shouldn’t be allowed to operate at all, given their dubious practices and the public dollars that feed their executives’ six-figure salaries. After all, this is public money that could go to actual health services and support for people and families trying to make ends meet.

Mary Alice Carter is senior advisor to Equity Forward. She has more than two decades of experience in the reproductive rights and health movements designing and managing effective earned and paid media campaigns.