As chief executive of Planned Parenthood of Southwest and Central Florida, Stephanie Fraim employs nearly 200 people to provide women’s health services, ranging from cancer screenings to abortions.
After Planned Parenthood began limiting in-person appointments in response to coronavirus earlier this year, Ms Fraim’s revenues halved.
“When you have that kind of precipitous drop in your revenue, you have to look at your expenses,” she said, explaining how she weighed laying off workers to stay afloat.
However, in early April, after US President Donald Trump signed the $2.2tn Cares Act into law, Ms Fraim successfully applied for a federal loan under the Paycheck Protection Program, a scheme intended to allow small businesses to keep employees on payroll.
Ms Fraim’s organisation, which has a non-profit tax status, was granted more than $2m in federal relief, which it used to retain its workforce and pay utilities and rent at its 10 health centres.
But one month later, Ms Fraim and other healthcare providers found themselves under scrutiny, after Fox News reported that nearly three-dozen Planned Parenthood affiliates had received about $80m in PPP loans. The report sparked outrage from Republicans on Capitol Hill, who said the abortion providers, as part of the wider Planned Parenthood network, did not qualify for funding, and demanded the money be returned.
Dozens of Republican senators have called for the US Department of Justice to investigate the matter. The Small Business Administration, the federal agency administering PPP, has written to Ms Fraim asking for the money back.
Ms Fraim said her organisation “did nothing wrong”, and she responded to the SBA with a “very strong challenge”, given non-profits with similar corporate structures, such as the United Way and the Girl Scouts, also qualified for loans.
“We are in the middle of one of the greatest healthcare crises, certainly in any of our lifetimes and one would argue in the past 100 years, and the fact that they would take time and energy to focus on what’s clearly a politically motivated attack is appalling,” she said.
The dispute over PPP illustrates how long-running debates over abortion in the US have been amplified by the coronavirus pandemic. According to the Kaiser Family Foundation, which researches health policy, nearly a dozen states have made public health emergency declarations to define abortions as non-essential or elective health procedures, and banned abortions until the end of the Covid-19 crisis.
While many of those bans have since been lifted, Kristin Ford, national communications director at Naral Pro-Choice America, said they showed anti-abortion activists were “exploiting a pandemic to achieve their ideological agenda”.
At the same time, abortion opponents accuse pro-choice groups of capitalising on the crisis.
A lawsuit filed last month by the ACLU on behalf of the American College of Obstetricians and Gynecologists called on the US Food and Drug Administration to lift rules requiring women to pick up mifepristone, an abortion drug, in person from a healthcare provider during the pandemic.
“They want to be able to just chat with somebody, interact with them on an app or in a phone call, and send these pills out by mail,” said Kristi Hamrick, a spokesperson for Students for Life of America. “That is egregious. It is so disingenuous, because it is women’s lives that are at stake.”
Julia Kaye, a staff attorney with the ACLU, said there was “absolutely no medical or rational explanation” for the drug to be obtained in person.
Abortion has long been a lightning rod issue in American politics, and public opinion has remained remarkably consistent. According to Gallup, 53 per cent of Americans say abortion should be “legal only under certain circumstances”, compared with 25 per cent who say it should be “legal under any circumstances” and 21 per cent who say it should be illegal in all circumstances”, virtually unchanged from when the question was first asked in the mid-1970s.
But Republicans and Democrats alike have hardened their positions in recent years. Many conservatives, including Mr Trump, have pushed for the US Supreme Court to overturn Roe vs Wade, the landmark 1973 decision that established a woman’s legal right to an abortion.
At the same time, Joe Biden, the presumptive Democratic presidential nominee, last year dropped his longstanding support for the Hyde Amendment, which bans the use of federal funding for abortion services, underscoring how the Democratic party has moved to the left on the issue. Planned Parenthood Action Fund, the group’s political arm, on Monday endorsed Mr Biden.
The Supreme Court is considering a challenge to a Louisiana law that requires doctors who perform abortions to have “admitting privileges” at nearby hospitals. It is the first abortion-related case to be heard by the court since Neil Gorsuch and Brett Kavanaugh, two of Mr Trump’s appointees, joined the bench. A ruling is expected as soon as this month.
The nine-member Supreme Court on Monday ruled 6-3 that gay and transgender workers are protected by federal civil rights laws in a landmark anti-discrimination decision.
Johanna Schoen, a professor at Rutgers University and an expert in the history of reproductive rights, said the Covid-19 pandemic had brought abortion “to the fore in a way where everybody is trying to advance their position”.
“I think of it as sometimes the noise level is higher than at other times, and at the moment it is higher because there are more opportunities to make access more difficult,” she said.
With less than five months to go until US presidential elections, activists on both sides maintain their case will resonate with voters.
“We know that these issues are incredibly salient in a political context in terms of changing people’s minds and overcoming their desire to vote for a Democrat based on other issues like climate change or healthcare,” said Mallory Quigley, vice-president of communications for the Susan B Anthony List, an anti-abortion political group.
But Ms Ford of Naral said that with polling consistently showing the overwhelming majority of Americans do not want to overturn Roe vs Wade, pro-choice groups had an advantage.
“Voters know that Trump swung the balance of the court towards the conservative, anti-choice majority, so all of the shenanigans on Capitol Hill and in state houses with these misplaced priorities are also set against this backdrop of just how much is at stake for reproductive freedom at the Supreme Court,” she said.