Two years after Roe was overturned, Texas leads the nation in funding for disaster being pregnant facilities. The system is supposed to assist rising households, but it surely’s riddled with waste and lacks oversight.
This story was initially revealed by ProPublica.
12 months after yr, whereas Roe v. Wade was the legislation of the land, Texas legislators handed measures limiting entry to abortion—who might have one, how and the place. And with the identical cadence, they added tens of millions of {dollars} to a program designed to discourage individuals from terminating pregnancies.
Their funds infusions for the Alternate options to Abortion program grew with virtually each legislative session—first progressively, then dramatically—from $5 million beginning in 2005 to $140 million after the U.S. Supreme Court docket overturned the proper to an abortion.
Now that abortion is essentially unlawful in Texas, lawmakers say they’ve shifted the aim of this system, and its tens of millions of {dollars}, to supporting households affected by the state’s ban.
Within the phrases of Rep. Jeff Leach, a Republican from Plano, the aim is to “present the total assist and assets of the state authorities … to return alongside of those 1000’s of girls and their households who may discover themselves with sudden, unplanned pregnancies.”
However an investigation by ProPublica and CBS Information discovered that the system that funnels a rising pot of state cash to antiabortion nonprofits has few safeguards and is riddled with waste.
Officers with the Well being and Human Companies Fee, which oversees this system, don’t know the specifics of how tens of tens of millions of taxpayer {dollars} are being spent or whether or not that cash is addressing households’ wants.
In some instances, taxpayers are paying these teams to distribute items they obtained at no cost, permitting antiabortion facilities—which are sometimes referred to as “disaster being pregnant facilities” and could also be set as much as appear to be clinics that carry out abortions—to invoice $14 at hand out a few donated diapers.
Distributing a single pamphlet can web the identical $14 payment. The state has paid the charities tens of millions to distribute such “academic supplies” about matters together with parenting and adoption; it could possibly’t say precisely what number of tens of millions as a result of it doesn’t gather knowledge on the products it’s paying for. State officers declined to offer examples of the supplies by publication time, and reporters who visited being pregnant facilities had been turned away.
Funding for Texas’ Antiabortion Program Has Skyrocketed
As they restricted entry to abortion, lawmakers additionally poured cash right into a program that was first referred to as Alternate options to Abortion and not too long ago rebranded as Thriving Texas Households. This system funds counseling, child objects and brochures, however not medical care.
For years, Texas officers have failed to make sure spending is correct or productive.
They didn’t conduct an audit of this system within the wake of revelations in 2021 that a subcontractor had used taxpayer funds to function a smoke store and to purchase land for hemp manufacturing.
They ramped up funding to this system in 2022 even after some contractors failed to satisfy their few targets for fulfillment.
After a legislative mandate handed in 2023, lawmakers ordered the fee to arrange a system to measure the efficiency and influence of this system.
One yr later, Well being and Human Companies says it’s “working to implement the provisions of the legislation.” Company spokespeople answered some questions however declined interview requests. They mentioned their important contractor, Texas Being pregnant Care Community, was chargeable for most program oversight.
The nonprofit community receives essentially the most funding of this system’s 4 contractors and oversees dozens of disaster being pregnant facilities, faith-based teams and different charities that function subcontractors.
The community’s government director, Nicole Neeley, mentioned these subcontractors have broad freedom over how they spend income from the state. For instance, they’ll reserve it or use it for constructing renovations.
Being pregnant Middle of the Coastal Bend in Corpus Christi, as an example, constructed up a $1.6 million surplus from 2020 to 2022. Govt director Jana Pinson mentioned two years in the past that she plans to make use of state funds to construct a brand new facility. She didn’t reply to requests for remark. A ProPublica reporter visited the waterfront plot the place that facility was deliberate and located an empty lot.
As a result of subcontractors are paid set charges for his or her companies, Neeley mentioned, “what they do with the {dollars} of their financial institution accounts will not be related” to the Thriving Texas Households program. “It’s now not taxpayer cash.”
The state mentioned these funds are, the truth is, taxpayer cash. “HHSC takes stewardship of taxpayer {dollars}, appropriated by the legislature, very critically by guaranteeing they’re used for his or her supposed function,” a spokesperson mentioned.
None of that has prompted lawmakers to cease the money from flowing. In truth, final yr they blocked necessities to make sure sure companies had been evidence-based.
Leach, one of many program’s most ardent supporters, mentioned in an interview with ProPublica and CBS Information that he would search accountability “if taxpayer {dollars} aren’t being spent appropriately.” However he remained assured about this system, saying the state would maintain investing in it. In truth, he mentioned, “We’re going to double down.”
What’s extra, lawmakers across the nation are contemplating applications modeled on Alternate options to Abortion.
Final yr, Tennessee lawmakers directed $20 million to fund disaster being pregnant facilities and related nonprofits. And Florida enacted a 6-week abortion ban whereas together with in the identical invoice a $25 million allocation to assist disaster being pregnant facilities. John McNamara, a longtime chief of Texas Being pregnant Care Community, has been working to begin related networks in Kansas, Oklahoma and Iowa. He’s additionally reserved the identify Louisiana Being pregnant Care Community.
And U.S. Home Republicans are advocating for permitting federal {dollars} from the Short-term Help for Needy Households program—supposed to assist low-income households—to movement to being pregnant facilities. In January, the Home handed the laws, and it’s pending within the Senate. Rep. Elise Stefanik (R-N.Y.), castigated Democrats for voting in opposition to the invoice.
“That’s taking away diapers, that’s taking away assets from households who’re in want,” she mentioned in an interview with CBS Information after the vote.
However, as Texas reveals, extra funding doesn’t essentially pay for extra diapers, formulation or different assist for households.
Watch the CBS Information Report
Lawmakers rebranded Alternate options to Abortion as Thriving Texas Households in 2023. This system is meant to advertise pregnancies, encourage household formation and enhance financial self-sufficiency.
The state pays 4 contractors to run this system. The most important, which will get about 80 % of the state funding, is the antiabortion group Texas Being pregnant Care Community.
Human Coalition, which will get about 16 % of the state funding, mentioned it makes use of the cash to offer shoppers with materials items, counseling, referrals to authorities help and schooling. Austin LifeCare, which will get about 3 % of the state funding, couldn’t be reached for remark about this story. Longview Wellness Middle in East Texas, which receives lower than 1 % of the funds, mentioned the state routinely audits its bills to make sure it’s working inside tips.
Texas Being pregnant Care Community manages dozens of subcontractors that present counseling and parenting courses and that distribute materials help resembling diapers and formulation. Dad and mom should take a category or bear counseling earlier than they’ll get these items.
The state may be charged $14 every time one in every of these subcontractors distributes objects from one in every of a number of classes, together with meals, clothes and academic supplies. Meaning the distribution of a few academic pamphlets might web the identical $14 payment as a a lot pricier pack of diapers.
A single go to by a shopper to a subcontractor may end up in a number of fees stacking up. Facilities are eligible to gather the charges no matter what number of objects are distributed or how a lot they’re price. One April morning, a shopper at McAllen Being pregnant Middle, close to the Texas-Mexico border, obtained a bag with some diapers, a child outfit, a child blanket, a pack of wipes, a child brush, a snack and two pamphlets. It was not clear how a lot the middle invoiced for these things.
McAllen Being pregnant Middle and different Texas Being pregnant Care Community subcontractors had been paid greater than $54 million from 2021 to 2023 for distributing this stuff, in keeping with information.
How a lot of that was for handing out pamphlets? The state mentioned it didn’t know; it doesn’t gather knowledge on the portions or sorts of objects supplied to shoppers or whether or not they’re important objects like diapers or simply pamphlets, making it not possible for the general public to understand how tax {dollars} had been spent.
Neeley mentioned in an e-mail that academic supplies like pamphlets solely accounted for 12 % of the cash reimbursed on this class final yr, or roughly $2.4 million out of $20 million. She didn’t reply to questions from ProPublica and CBS Information about proof that may corroborate that quantity.
The best way subcontractors are paid, and what they’re allowed to do with that cash, raised questions amongst charity consultants consulted for this investigation.
Within the nonprofit sector, utilizing a fee-for-service cost mannequin for materials help is extremely uncommon, mentioned Vincent Francisco, a professor on the College of Kansas who has labored as a nonprofit administrator, evaluator and advisor over the previous three many years. It “can run quick and unfastened should you’re not cautious,” he mentioned.
Even when nonprofits distribute objects they acquired at no cost or near it, the state will nonetheless reimburse them. Take Viola’s Home, a being pregnant middle and maternity house in Dallas. Data present that it pays a close-by diaper financial institution an administrative payment of $1,590 for about 120,000 diapers yearly—simply over a penny apiece. Viola’s Home can then invoice the state $14 for distributing a pack of diapers that value the middle simply over 1 / 4.
However earlier than they’ll get these diapers, mother and father should take a category. The middle also can invoice the state $30 for every hour of sophistication a shopper attends.
Rep. Donna Howard, a Democrat from Austin, mentioned this system may very well be extra environment friendly if the state funded the diaper banks immediately. Final yr, she proposed diverting 2 % of Thriving Texas Households’ funding on to diaper banks, however the proposal failed.
Data present that in fiscal yr 2023, Viola’s Home obtained greater than $1 million from the state in reimbursements for materials assist and academic objects plus one other $1.7 million for courses. Govt Director Thana Hickman-Simmons mentioned Viola’s Home depends on funding from an array of sources and that only a small fraction of the diapers it distributes come from the diaper financial institution. She mentioned the state cash “might by no means cowl all the pieces that we do.”
In some instances, reimbursements have created a hefty cushion within the budgets of subcontractors. The state doesn’t require them to spend the taxpayer funds they get on needy households, and Texas Being pregnant Care Community mentioned subcontractors can spend the cash as they see match, so long as they observe Inside Income Service guidelines for nonprofits.
McAllen Being pregnant Middle obtained $3.5 million in taxpayer cash from Texas Being pregnant Care Community over three years, but it surely spent lower than $1 million on program companies, in keeping with annual returns it filed with the IRS. In the meantime, $2.1 million was added to the group’s belongings, principally in money. Its government director, Angie Arviso, requested a reporter who visited in particular person to submit questions in writing, however she by no means responded.
Texas Taxpayers Gave One Disaster Being pregnant Middle $3.5 Million Over Three Years. It Spent Much less Than $1 Million on Packages.
The nonprofit McAllen Being pregnant Middle is a case examine displaying how antiabortion facilities can amass a surplus from the Alternate options to Abortion program, which is now referred to as Thriving Texas Households.
“It is a coverage selection Texas has made,” mentioned Samuel Brunson, affiliate dean for college analysis and growth on the Loyola College Chicago Faculty of Regulation, who researches and writes concerning the federal revenue tax and nonprofit organizations. “It has chosen to redistribute cash from taxpayers to the reserve funds of personal nonprofit organizations.”
Tax consultants say that’s problematic. “Why would you give cash to a recipient that’s not spending it?” mentioned Ge Bai, a professor of accounting and well being coverage at Johns Hopkins College.
The tax consultants disagree with Texas Being pregnant Care Community’s argument that the cash is now not taxpayer {dollars} after its subcontractors are paid.
“It’s nonetheless the federal government shopping for one thing,” mentioned Jason Coupet, affiliate professor of public administration and coverage at Georgia State College, who has studied effectivity within the public and nonprofit sectors. “If I had been within the auditor’s workplace, that’s the place I’d begin having questions.”
State legislators and regulators haven’t put in oversight protections in this system.
Three years in the past, The Texas Tribune spotlighted the state’s refusal to trace outcomes or search perception into how subcontractors have spent taxpayer cash.
Months later, Texas Being pregnant Care Community minimize off funding to one in every of its largest subcontractors after a San Antonio information outlet alleged the nonprofit had misspent cash from the state.
KSAT-TV reported that the nonprofit, A New Life for a New Technology, had used Alternate options to Abortion funds for holidays and a bike, and to fund a smoke store enterprise owned by the middle’s president and CEO, Marquica Reed. It additionally spent $25,000 on land that was later registered by a member of Reed’s household to provide industrial hemp.
In an interview with ProPublica, a former case supervisor recalled how Reed would get offended if workers forgot to invoice the state for a service supplied to a shopper.
The previous case supervisor, Bridgett Warren Campbell, mentioned workers would purchase diapers from the native Sam’s Membership retailer, then take aside the packages. “We’d take the diapers out and provides mother and father two to a few diapers at a time, then she would invoice TPCN,” mentioned Campbell.
Reed declined to remark to a ProPublica reporter or to reply follow-up questions through e-mail or textual content. Neeley, the Texas Being pregnant Care Community’s government director, mentioned the being pregnant middle was faraway from this system as a result of its nonprofit standing was in jeopardy, not as a result of it had used cash on private spending. She mentioned the community wasn’t chargeable for monitoring how A New Life for a New Technology spent its {dollars}: “The ability to research these issues of how nonprofits handle their very own funds is reserved statutorily to the Texas Lawyer Common and the IRS.”
The Texas legal professional basic’s workplace wouldn’t say whether or not it has investigated the group. Data present that after KSAT’s story, state officers referred the case to an inspector basic and that the Texas Being pregnant Care Community submitted a report detailing the way it monitored the subcontractor.
The state requires contractors to submit impartial monetary audits in the event that they obtain a minimum of $750,000 in state cash; Texas Being pregnant Care Community meets this threshold. Nonetheless, its dozens of subcontractors don’t must submit these audits — one thing consultants in nonprofit practices mentioned ought to be required. Within the fiscal yr earlier than the alleged misspending got here to gentle, A New Life for a New Technology obtained greater than $1 million in reimbursements from the state, information present.
When ProPublica and CBS Information requested how the Well being and Human Companies Fee detects fraud or misuse of taxpayer funds, Jennifer Ruffcorn, a fee spokesperson, mentioned the company “performs oversight by way of numerous strategies, which can embrace fiscal, programmatic, and administrative monitoring, enhanced monitoring, desk critiques, monetary reconciliations, on-site visits, and coaching and technical help.”
By a spokesperson, Rob Ries, the deputy government commissioner who oversees this system at Well being and Human Companies, declined to be interviewed.
The company has by no means completely evaluated the effectiveness of this system’s companies in its practically 20 years of existence.
It’s supposed to ensure its contractors are assembly a number of benchmarks: what number of shoppers each serves and what number of they’ve referred to Medicaid and the Nurse-Household Partnership, a program that sends nurses to the properties of low-income first-time moms and has been confirmed to cut back maternal deaths. The Nurse-Household Partnership doesn’t obtain Alternate options to Abortion funding.
In 2022, the Texas Being pregnant Care Community failed to satisfy two of three key benchmarks in its contract with the state: It didn’t serve sufficient shoppers and it didn’t refer sufficient of them to the nursing program. The state didn’t withhold or scale back its funding. McNamara disputed the primary declare, saying the state modified its methodology for counting shoppers, and mentioned the opposite benchmark was troublesome to hit as a result of too few shoppers certified for the nursing program.
In Could 2023, when lawmakers handed the invoice rebranding this system, the state additionally ordered the company to “determine indicators to measure the efficiency outcomes,” “require periodic reporting” and rent an outdoor occasion to conduct influence evaluations.
The company declined to share particulars about its progress on these necessities besides to say that it’s inquiring for influence analysis companies. Data present the company has requested bids.
Lawmakers determined final yr in opposition to enacting necessities that may guarantee sure companies had been evidence-based—confirmed by analysis to satisfy their objectives—as an alternative siding with an argument that they might be too onerous for smaller nonprofits.
Texas’ six-week abortion ban took impact in 2021, and greater than 16,000 extra infants had been born within the state the next yr. Teachers count on that pattern to proceed.
However the security web for fogeys and infants is paper skinny.
Texas has the lowest fee of insured ladies of reproductive age within the nation and ranks above the nationwide common for maternal deaths. It’s final in giving money help to households residing beneath the poverty line.
Moms advised reporters they’re struggling to scrape collectively sufficient diapers and wipes to maintain their infants clear. A San Antonio diaper financial institution has lots of of households on its waitlist. Outdoors an Austin meals pantry, traces snake across the block.
Howard, the Austin state consultant, mentioned ProPublica and CBS Information’ findings present that this system wants extra oversight. “It’s unconscionable {that a} [Thriving Texas Families] supplier can be allowed to maintain tens of millions in reserve when there’s a super want for extra funding in entry to well being care companies,” she mentioned.
Do you may have any tips about state-funded antiabortion applications? Cassandra Jaramillo may be reached by e-mail at cassandra.jaramillo@propublica.org or by Sign at 469-606-9665.
Caroline Chen and Kavitha Surana contributed reporting.
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