CREDIT: AP Photo/iStock/Dylan Petrohilos

Millions in TANF dollars are flowing to crisis pregnancy centers that mislead women.

By Bryce Covert and Josh Israel

Missouri has a poverty problem.

Almost 15 percent of the state’s residents live under the federal poverty line, a bare-bones guideline that means existing on $20,160 or less a year for a family of three. One in five Missouri children lives in poverty. It ranks 30th in the country for its share of poor people.

That kind of destitution can make it difficult to get enough food to eat. Missouri has the second-highest share of residents who have very low food security in the country. Almost 8 percent of residents fall into this category; only Arkansas has more people struggling to afford food.

In such a climate, it might be reasonable to expect state lawmakers to be focused on how to alleviate economic suffering. But over the past five years, the number of people in Missouri receiving benefits from its welfare program has plummeted, falling by more than 100,000 people since 2011. The most recent monthly statistics show that only 37,486 people were getting cash assistance.

That’s thanks to harsh measures lawmakers have put in place for those who need some help to get by. Lawmakers have cut people off after 45 months no matter whether they have a job or source of income — the federal cutoff is five years. They’ve also forced recipients to create “personal responsibility plans” outlining work activities with the ability to lose benefits if they go off course.

States have gotten a fixed amount of money from the federal government to run their welfare programs since 1996, or when welfare reform turned it into the Temporary Assistance for Needy Families (TANF) block grant. So when there are fewer people getting cash benefits, that means a state has more money left over that it can put toward other purposes. And in Missouri, one big purpose consuming the funding has been something that might seem unrelated to alleviating poverty: crisis pregnancy centers (CPCs), or organizations that run with the express purpose of discouraging women from getting abortions, often through misleading them or flat out lying to them.

According to data collected by ThinkProgress, Missouri is one of seven states, including Indiana, Ohio, Pennsylvania, Michigan, North Dakota, and Texas, that use federal TANF dollars to fund crisis pregnancy centers.

All told, over the past four years these seven states have diverted more than $30 million of federal money meant for welfare to anti-abortion programs that fund crisis pregnancy centers.

TANF money used for a CPC is necessarily money that isn’t going to cash benefits or other measures that might help someone climb out of poverty. “When you start diluting TANF dollars, you are inevitably taking resources from the intended recipients of TANF benefits, which are oftentimes hungry children,” said James Owens, state communications director at NARAL Pro-Choice America, which has tracked the growth of CPCs and how they’re funded.

But funding CPCs with TANF money isn’t new. It’s a practice that originated in Pennsylvania in 2001. Rick Santorum, a Republican Senator from the state at the time, sent a letter to the U.S. Department of Health and Human Services (HHS) asking whether the state could use TANF funds for alternatives to abortion services. The Bush administration’s HHS leadership approved it, and the state sent $1 million in welfare money to CPCs that year, making it the first state in the country to use the money this way.

CREDIT: ThinkProgress/Dylan Petrohilos

Since then, more and more states have followed suit. Missouri has been an enthusiastic participant in the trend. Missouri gives CPCs one of the largest sums, doling out $4.3 million for the most recent fiscal year to alternatives to abortion services, most or all of which goes to CPCs.

CREDIT: Dylan Petrohilos

It’s second only to Texas, which handed out $9.15 million in fiscal year 2016 alone and has given CPCs more than $23 million in welfare money since 2013.

CREDIT: ThinkProgress/Dylan Petrohilos

Missouri has a lot of crisis pregnancy centers, but not a lot of places where a woman who wants an abortion can get one. According to NARAL, there are 63 CPCs throughout the state, yet there’s just one abortion provider.

What strains credulity is how the states justify using TANF money in this way. According to the rules guiding TANF, the way states deploy their funding has to fall under at least one of the program’s four core purposes: providing assistance to needy families, promoting job preparation and work, preventing and reducing out-of-wedlock pregnancies, and/or encouraging marriage and two-parent families.

“TANF dollars are given for a reason,” Owens noted. “That reason does not include lying to women about their pregnancy options.”

But HHS, which oversees TANF, rarely enforces those rules.

A spokesman for the U.S. Department of Health and Human Services Administration for Children & Families said in an email that states must provide a plan describing “how the program is meeting federal requirements” and must notify the department within 30 days of any changes. Staff reviews all plans and amendments, but he noted, “HHS does not ‘approve’ a state’s TANF plan.” It merely “determines completeness of the required elements of the federal law.”

That’s given these states huge latitude to justify spending the money on crisis pregnancy centers. When asked, at least one state invoked each of the four possible reasons, suggesting that by funding “alternatives to abortion,” it is somehow helping the needy, preparing people for jobs, discouraging out-of-wedlock births, and pushing people toward marriage. North Dakota and Texas declined to cite any rationale; a spokesman for Michigan’s Department of Health and Human Services said that it has not yet determined how to justify the spending but said it would most certainly meet “at least one of the goals — if not all four.”

CREDIT: ThinkProgress/Dylan Petrohilos

CREDIT: ThinkProgress/Dylan Petrohilos

CREDIT: ThinkProgress/Dylan Petrohilos

CREDIT: ThinkProgress/Dylan Petrohilos

It’s hard to see how CPCs fulfill any of these goals, however.

NARAL’s research backs up the claim that crisis pregnancy centers lie to women. The centers are often purposely made to look like medical offices and are often situated near an actual abortion provider or women’s health clinic. They promise to offer holistic counseling for women with unintended pregnancies, but the umbrella organizations that run them are upfront about their ideological mission: to eliminate abortion by steering women away from it.

Once inside a CPC, women are often giving misleading or outright false information. Seventy percent of CPCs in Massachusetts gave out pamphlets that claimed abortion leads to a number of severe medical risks despite the fact that it is one of the safest medical procedures. Most of the organizations’ literature makes false claims about a risk of breast cancer, infertility, and “post-abortion syndrome.”

They have also been found to give inaccurate information about contraception. One center told women that condoms are porous; nearly half of North Carolina’s CPCs were found to be telling women that none of the common methods of birth control are effective at preventing pregnancy. Yet preventing unwanted pregnancies is not just one of the main goals of TANF, but one that is commonly used as justification for spending the money on CPCs.

“They give a whole slew of lies and half truths to mislead women and coerce them out of being able to take advantage of the full range of reproductive health options,” Owens said. “That’s not helping teens avoid unwanted pregnancies. To the extent that [states] would be rationalizing using this money to reduce teen pregnancy, funding crisis pregnancy centers is clearly not the way to do that.”

Meanwhile, abortion, despite its political touchiness, has been shown to reduce poverty. Researchers have found that women who tried to get an abortion but were turned away were three times more likely to fall below the poverty line over the next two years than the women who successfully obtained abortions. Women themselves report that one of the most frequent reasons that they seek an abortion is because they can’t afford to have a child. Abortions can also allow women to continue working, as another common reason women give for getting one is that a child would have interfered with work or education.

“Crisis pregnancy centers work actively against every single one of [TANF’s] four goals,” Owens said.

Yet the issue continues to fly under the radar, perhaps in part because of how crisis pregnancy centers justify what they do, or perhaps the lack of transparency around how this money is getting to them. “They have been so successful in hiding in plain sight, so successful in telling a story about how they’re there to help women and provide health care, that a lot of states have started to fund them directly,” Owens said. “They’ve built up this image of themselves as halfway credible organizations.” At least eleven states give CPCs money out of their own budgets, some of the same ones sending federal TANF dollars their way.

And rather than putting a line item in the state’s TANF allocation for crisis pregnancy centers, the money will be allocated to alternatives to abortion services — but nearly all of that money ends up going to CPCs.

“There’s not that much transparency about what is being funded and who’s getting funds, what kinds of services are being provided and who is providing services,” noted Elizabeth Nash, senior state issues manager with the Guttmacher Institute, a research organization focused on reproductive health and rights.

But once states start funding crisis pregnancy centers, they rarely reverse course. “Typically once it gets in, it doesn’t get deleted,” Nash said. “It’s there and nobody says much about it.”