The Magazine

Planned Parenthood's Unseemly Empire

The billion-dollar "non-profit."

Oct 22, 2007, Vol. 13, No. 06 • By CHARLOTTE ALLEN
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In mid-July the top three Democratic presidential contenders paid their respects at an important shrine on the pilgrimage circuit of party fundraising: the Washington-based political arm of the Planned Parenthood Federation of America. With its unceasing and aggressive advocacy of what it calls "women's reproductive health," Planned Parenthood has come to function as a gatekeeper to the treasuries of the progressive-minded Hollywood and Silicon Valley millionaires and billionaires who (along with their family foundations) increasingly control the purse-strings of the Democratic party during national elections, and for whom the right to unrestricted abortion for females of all ages is the sacred cynosure of the Constitution. And so they came to Planned Parenthood, clearly coveting the endorsement that would open the fundraising spigot and declaring that they were on board with the Planned Parenthood agenda 200 percent: Barack Obama, John Edwards (who, campaigning that day in Pittsburgh, sent his wife Elizabeth), and Hillary Clinton.

It was Clinton, endorsed by Planned Parenthood for her 2000 and 2006 Senate races, who most deferentially touched all the organization's advocacy bases as she denounced a range of Bush administration policies: the "global gag rule" that prevents U.S. funds from going to entities that advocate abortion overseas (read: Planned Parenthood's international arm), programs that promote abstinence-only sex education (not the programs of Planned Parenthood), the Supreme Court's upholding of the federal ban on partial-birth abortion (thanks in part to the Bush-appointed justices John Roberts and Samuel Alito), and the supposed flat-lining of funding during the Bush years (actually the amounts appropriated by Congress generally increased) for Title X, a federal program that dispenses free birth control to high-school girls without their parents' knowledge (Planned Parenthood is heavily involved). Clinton promised to reverse all those Bush-era developments, and also threw in some extra goodies: a bill she had introduced that would make the "morning-after" pill (heavily promoted at Planned Parenthood clinics) easier to obtain at military bases. According to the New York Times's political blog, Clinton declared, "When I'm president, I will devote my very first day in office to reversing these ideological, anti-science, anti-prevention policies that this administration has put into place."

Hard on the heels of the Planned Parenthood schmoozefest came the sort of news story that would send most high-profile nonprofits into a PR tailspin. On August 1 in West Hartford, Connecticut, charges of criminal abduction were filed against a 41-year-old dog trainer named Adam Gault. For nearly a year, Gault had allegedly hidden a runaway girl, now 15, in the house he shared, Hugh Hefner-style, with two other girlfriends (ages 26 and 40 and also charged with crimes arising from the incident). He had gotten the teenager pregnant and procured an abortion for her on May 1 at a Planned Parenthood clinic in West Hartford. About a month later, police discovered the 15-year-old, whose mother had been searching frantically for her since her disappearance from home in June 2006, locked in a storage space under a staircase at the residence of Gault, a onetime workplace acquaintance of the girl's stepfather. A DNA test on the corpse of the fetus indicated that Gault was its father. It is not known what sort of identification the girl, too young for a driver's license, presented the clinic's administrators. She apparently wouldn't name the father, and it is all but certain that no one at Planned Parenthood went out of their way to inquire into the circumstances that led to her pregnancy.

These allegations of egregious statutory rape involving a girl of 15 and a polyamorous middle-aged ne'er-do-well are of a piece with any number of incidents at Planned Parenthood clinics in which personnel have either looked the other way or stated their willingness to look the other way in the face of state laws requiring the reporting of suspected sexual abuse of minors under the age of 16. In one of those cases, the abuser, now serving a five-year prison sentence, was the victim's own father, who had forced his daughter to share his bed and have sex with him starting at age 13; another, involving the same Planned Parenthood branch in Cincinnati, Ohio, also featured a 13-year-old, this one impregnated by her school soccer coach who accompanied her to the clinic and paid for the abortion with his credit card, while she showed the staff her junior high school ID card. Spokesmen for Planned Parenthood have insisted that such cases are flukes (or that the victims lied, relieving the clinics of responsibility), and that clinic staff are carefully trained to report all instances of suspected abuse.

No matter what one may think about abortion, episodes such as those above would turn most charitable organizations into political pariahs. Not Planned Parenthood. The mammoth tax-exempt nonprofit with 122 affiliates nationwide reported revenues in June of a record $903 million during its 2005-06 fiscal year, and it continues to bask in an amazingly exalted reputation, at least among Democratic politicos, celebrities, a largely sympathetic and even sycophantic press, and the gigantic family foundations set up by such tycoons past and present as David Rockefeller, David Packard, Bill Gates, and the ubiquitous George Soros, all of whom have donated hundreds of millions of dollars to Planned Parenthood causes. Among upper-middle-class Americans who pride themselves on their progressive views, the name "Planned Parenthood" still conjures up founder Margaret Sanger's long-ago crusade against the Comstock Laws that once outlawed contraceptive devices even for married couples. It also still conjures up images of adult women taking rational steps to postpone childbearing and limit family size so as to fit their economic and emotional needs--not unwed high school girls seeking clandestine abortions that won't get the creepy adults who impregnated them in trouble with the law.

Planned Parenthood also trades on most people's relaxed attitudes toward sex and birth control. Although certain religious groups, notably the Catholic church, frown on artificial contraception, the overwhelming majority of Americans (including Catholics) see nothing wrong with, and much good to be gained from, planning births via whatever medical devices are deemed safe and effective. Nor do many Americans object nowadays to young people, even teens, having sex before marriage, as long as it is not outrageously promiscuous or coercive--and under such circumstances, birth control strikes them as essential. Although most Americans are distressed by abortion, and many would like to restrict it by varying degrees (they are largely prevented from so doing by the Supreme Court's 1973 ruling in Roe v. Wade declaring it a constitutional right), few, even among political conservatives, wish to ban the procedure altogether, and many who are morally repulsed by abortion do not believe that women should be restrained by law from choosing it.

Someone, then, has to do the dirty work, and in many people's thinking, that someone should preferably not be the corner-cutting medical hacks (who else would want to be an abortionist?) who staff many a for-profit clinic and pop up in occasional news stories about women killed or seriously injured in botched procedures at seedy facilities reminiscent of the legendary back-alley abortionist's lair that Roe v. Wade was supposed to have abolished. That's where Planned Parenthood steps in: It's the nice abortion provider. The organization's cleanly designed powder blue-and-white website abounds with the words safe, health, trust, medical standards, high quality, and training, along with soothing photographs of crisply groomed, white-clad professionals, most of them female.

Other literature from Planned Parenthood portrays the organization's abortion business as a tiny droplet in an ocean of medical and social services focused on prevention of pregnancy--along with such worthy works as screening for sexually transmitted diseases and reproduction-related cancers, and even prenatal care. "Prevention is the cornerstone of our services," declares Planned Parenthood's online financial report for 2005-06. The organization boasts that 81 percent of the clients at its 860 or so "health centers" nationwide received some sort of contraceptive. A pie graph accompanying these statements displays "abortion services" as representing a tiny sliver--just 3 percent--of the more than 10 million individual health services that Planned Parenthood provided during the last fiscal year, with contraception taking up 37 percent of the pie, tests and treatments of sexually transmitted diseases 29 percent, and cancer screening and prevention 20 percent. Indeed, the pro-choice but abortion-disapproving GOP presidential contender Rudy Giuliani defended the $900 that he donated to Planned Parenthood during the 1990s on the grounds that the organization "makes information available" about other options, including adoption, available to women facing crisis pregnancies.

Controlling family size, forestalling teen pregnancy, battling disease, reminding pregnant women that they don't have to abort--all good things, right? So good, in the eyes of many federal, state, and local legislators, that nearly one-third of Planned Parenthood's near-billion dollars in revenues--$305.3 million in 2005-06--came from government subsidies of one sort or another. Gross revenues from "health services" at clinics accounted for another $345.1 million, and "private contributions and bequests" accounted for $212.2 million. The federal government alone was responsible for $120 million or more (the last available figures date from 2001), with at least $59 million coming from the supposedly Bush-starved Title X program.

That's not bad for an organization that also boasted a total of $839.8 million in net assets for the 2005-06 fiscal year, up from $784.1 million for the previous financial year. Planned Parenthood also reported a $55.8 million surplus of revenue over expenses last fiscal year, which, if it were an ordinary taxpaying business, would have amounted to a tidy 6 percent profit. Thanks in part to government generosity, Planned Parenthood has more money than it can spend. Whatever one might think personally about abortion and birth control, it is certainly worth asking whether U.S. taxpayers should be digging into their pockets to support a cash-engorged organization that reported that it paid its outgoing president, Gloria Feldt, an annual compensation package approaching $1 million.

Planned Parenthood garners all the free positive publicity it can use from obsequious journalists and big names in the arts world. From Dear Abby on down, advice columnists of the newspaper world regularly urge Planned Parenthood services upon the lovelorn teens who seek their counsel. In June 2006, Vogue magazine ran a Vaseline-on-the-lens profile of the organization's newly installed president, Cecile Richards (daughter of the late Texas Democratic governor Ann Richards). The article was accompanied by a two-page photo spread of Richards sitting in her Manhattan office accompanied by five photogenic babies of various ethnicities serving as human props--as though Planned Parenthood were a fertility clinic instead of the opposite. (Although Planned Parenthood lists itself as offering "infertility services," only 248 people nationwide availed themselves of those services last fiscal year, the organization reported.) At a series of Planned Parenthood fundraisers, a raft of Hollywood and music luminaries, including Gwyneth Paltrow, the Dixie Chicks, James Gandolfini, Edie Falco, Whoopi Goldberg, Stanley Tucci, and Kathleen Turner donated free entertainment or (more frequently and at significantly less effort to themselves) autographed paraphernalia for auction.

Underneath this veil of media and show-business gossamer is an organization that, contrary to the impression it works hard to create, focuses obsessively on abortion, providing ever more abortions every year, reaching out to an ever-younger clientele. The 3 percent pie slice in the 2005-06 financial report, representing 264,943 abortion customers served, can only be described as deliberately misleading.

One way Planned Parenthood massages the numbers to make its abortion business look trivial is to unbundle its services for purposes of counting. Those 10.1 million different medical procedures in the last fiscal year, for instance, were administered to only 3 million clients. An abortion is invariably preceded by a pregnancy test--a separate service in Planned Parenthood's reckoning--and is almost always followed at the organization's clinics by a "going home" packet of contraceptives, which counts as another separate service. Throw in a pelvic exam and a lab test for STDs--you get the picture. In terms of absolute numbers of clients, one in three visited Planned Parenthood for a pregnancy test, and of those, a little under one in three had a Planned Parenthood abortion.

Moreover, in terms of revenues generated, abortion accounted for at least one-third, probably more, of Planned Parenthood's $345.1 million in clinic income reported for the last fiscal year. A no-frills (local anesthesia that does not hinder cramping), no-complications, first-trimester surgical abortion typically costs about $400. Multiply that by 264,943 and you have $106 million, more than 10 percent of Planned Parenthood's entire revenues from every source last fiscal year. Furthermore, many abortions cost more than $400. An extra $150 or so buys better, IV-administered, anesthesia; a "medication abortion" (RU‑486 plus a second drug that induces labor) costs about $450, and a second-trimester abortion can run to well over $1,000, depending on complications.

Even as the total number of abortions in this country has fallen, Planned Parenthood's market share has increased. Its abortions last fiscal year were at an all-time high, a 3 percent increase over the 255,015 abortions it performed in 2004-05, and amounted to 20 percent of the 1.3 million abortions performed in the United States during that period (the latter figure comes from the Guttmacher Institute, which began as Planned Parenthood's research arm). The number also culminates a doggedly steady rise, year after year after year, in the total number of abortions performed at Planned Parenthood facilities in the United States. In 1990, for example, Planned Parenthood clinics performed only 129,550 abortions, less than half of today's total and representing about 8 percent of the 1.6 million abortions performed in the U.S. that year. Since 1990 the total number of U.S. abortions has gradually drifted downward despite a rising overall population--the current 1.3 million a year marks the lowest number since 1974, the year after Roe v. Wade, according to the Guttmacher Institute--while Planned Parenthood's market share has more than doubled. "It's certainly the nation's largest abortion chain," says Randall K. O'Bannon, director of education and research for the National Right to Life Committee.

All this despite the fact that Planned Parenthood has been closing more clinics than it has opened over the past few years in order to cut overhead: The net number of its facilities has dwindled from a peak of 938 nationwide in 1995 to today's 860 or so. Furthermore, although Planned Parenthood's traffic in abortions and morning-after pills increased significantly during 2005-06 (along with its dispensing of conventional contraceptives and testing for STDs and HIV), the number of other medical services it provided actually fell during that period: screening for cervical and other cancers, prenatal care, even pregnancy tests. Indeed, the organization's gross clinic revenues of $345.1 million last year represented a $1.5 million decline from those of the previous fiscal year. And pace Rudy Giuliani, last fiscal year Planned Parenthood stopped even reporting its adoption referrals. Its 2004-05 report stated that it had referred only 1,414 clients to adoption agencies (that's less than two per clinic per year).

Abortion is clearly a cash cow for Planned Parenthood, but at least, one might think, having an abortion at a presumably state-of-the-art Planned Parenthood clinic is safer for the woman involved than it might be elsewhere. That may be so--although Planned Parenthood has seen its share of horror stories. For one, there's the case of 21-year-old Edrica Goode of Riverside, California, who died on February 14 of toxic shock syndrome allegedly caused by cervical dilators left inside her by a nurse at a Planned Parenthood facility as a prelude to a second-trimester abortion that never took place. Goode's mother, saying her daughter was never properly warned that the dilators could spread infections, filed a medical-malpractice lawsuit against Planned Parenthood in June.

The real medical controversy, though, stems from Planned Parenthood's burgeoning RU-486 practice. Six women are known to have died in this country between 2003 and 2006 after taking the abortion pill, whose generic name is mifepristone and which was approved by the federal Food and Drug Administration in 2000. Four of those six received the drug at Planned Parenthood clinics, where it was--and still is--administered in a fashion that does not comply with the FDA's protocols. Because mifepristone, which breaks down the uterine lining in order to starve the fetus, can cause severe bleeding and other life-threatening side effects, the FDA's guidelines state that both mifepristone and a second drug called misoprostol that induces labor and expels the fetus should be taken orally within two days of each other "under a physician's supervision"--that is, at a doctor's office.

Planned Parenthood, which had been running its own clinical tests on mifepristone throughout the 1990s (thus making it available to some women before FDA approval) decided as a matter of policy to skip the second office visit and instead give its clients the misoprostol in the form of a vaginal suppository (instead of the pill the FDA recommended) to insert on their own at home. Finally, after the third and fourth Planned Parenthood clients died last year (the causes of death for all six have included bacterial infections and an undetected ectopic pregnancy), the organization, which had ignored warnings from the FDA after the first two deaths, relented and switched to oral administration of the misoprostol--although it still permits its clients to take the drug at home, not at the clinic as the FDA advises. (Planned Parenthood has never publicly stated a reason for its continued refusal to comply with that part of the FDA's guidelines, although it is fair to surmise a combination of cost savings and convenience for the client have something to do with it.)

It is, of course, not uncommon for physicians to ignore the FDA's protocols for administering FDA-approved drugs, but it is surprising that Planned Parenthood is willing to risk the lives of its clients in order to assert its independence from federal regulators. Furthermore, at least one Planned Parenthood clinic, Planned Parenthood Golden Gate in Hayward, California, site of the RU-486 death of 18-year-old Holly Patterson in 2003, fails to comply with still another FDA guideline: that the mifepristone be administered no later than 49 days after the woman's last menstrual period (it is deemed ineffective after that); Golden Gate is willing to administer the drug a full 56 days into pregnancy, according to its website.

Most troubling of all is Planned Parenthood's pattern of seeming insouciance about reporting suspected sexual abuse by adults of underage girls--of which the Adam Gault case is perhaps the most spectacular example to date. Planned Parenthood heavily markets both its advocacy positions and its facilities and services to teenagers (via, among other things, ads on MySpace and MTV), and it has a huge clientele of high school students living at home (one affiliate, Planned Parenthood of Hawaii, told the Honolulu Star-Bulletin in 2001 that a full third of its clients were teens "with little or no money"). In recent years Planned Parenthood has opened a series of "express" storefront branches at shopping malls apparently aimed at funneling mallrats to its full-service clinics elsewhere. Last year Planned Parenthood Golden Gate launched a "Tell a Friend" marketing campaign that included free movie tickets and a chance to win an iPod as rewards to teens for sending their classmates to Planned Parenthood clinics.

A colorfully designed Planned Parenthood-sponsored website, Teenwire, pitched specifically at adolescents, features discussion boards and an "ask the experts" question-and-answer page on which young people, their anonymity protected by screen names, can pitch queries and air their views on sex-related topics that walk a fine line between the medically pertinent and the merely titillating ("can I get pregnant from anal sex?"). Links on Teenwire to Planned Parenthood's own website help visitors to Teenwire arrange for contraceptives and abortions at Planned Parenthood facilities. Another Teenwire page lists an 800 number that teens can call to obtain prescriptions at Planned Parenthood clinics for the morning-after pill, which can be sold over the counter in most states only to legal adults.

In all these endeavors there is an implicit promise by Planned Parenthood that no outside adult, especially the parents of the teen in question, will learn what any individual young person is up to. Planned Parenthood mounts intense advocacy campaigns against and court challenges to the laws in 35 states that require at least one parent either to give consent to or to be notified of a minor child's pending abortion. Last year the organization helped defeat Proposition 85, a California ballot measure that would have required parental notification. A page on Teenwire invites adolescents to become involved in such legislative maneuvers and tells them how to contact Planned Parenthood in order to do so. "Access to confidential abortion services is essential to teenagers' health," declares a page on Planned Parenthood's own site.

A large number, perhaps a majority, of underage teen pregnancies are not puppy love gone awry, but involve adult men who are significantly older than the pregnant girl. A study published in the journal Family Planning Perspectives in 1992 found that 62 percent of first-time births to teen mothers had been preceded by experiences of molestation, rape, or attempted rape, with the mean male-offender age 27.4 years. The Guttmacher Institute reported in 1995 that more than 40 percent of mothers age 15-17 had sexual partners three to five years older; nearly 20 percent had partners six or more years older.

Thus, Planned Parenthood's confidentiality principles can thus run squarely up against laws in every state, typically bearing criminal penalties, that require health care workers to report suspected incidents of sexual abuse or statutory rape to law enforcement. In 2002, a Texas-based pro-life group called Life Dynamics launched a sting operation, hiring an actress to call more than 800 abortion clinics nationwide, including many Planned Parenthood clinics. She told the receptionists that she was a 13-year-old girl who needed an abortion, except that her boyfriend was 22 and she didn't want him to get into trouble. The reported response at 91 percent of the clinics (including Planned Parenthood's) was: Don't mention your boyfriend's age when you come in, and all will be well. "[O]therwise, there's going to be a lot of stuff going on that you're probably not going to want to have happen," said a receptionist at a Planned Parenthood facility in New London, Connecticut, according to a Life Dynamics tape. Although Fox News reported the Life Dynamics story, the reaction of most of the media was: How dare anyone deceive a Planned Parenthood receptionist?

Real-life incidents involving minor teens who had abortions at Planned Parenthood clinics can make the fictional scenario invented by Life Dynamics pale by comparison. Brian Hurley, a lawyer representing the daughter molested for five years by the recently convicted John Blanks Jr. of Mason, Ohio, says the girl reported the years-long abuse to a Planned Parenthood Southwest Ohio employee when her father drove her there to have an abortion at age 16 after getting her pregnant--their response, according to Hurley, was to send the girl home in her father's car with a packet of birth-control pills. The abuse continued for another year and a half, the Cincinnati Enquirer reported, at which point the girl told her future college sports coach, who reported the coerced sex to authorities, launching the criminal investigation that led to Blanks's arrest, trial, and five-year prison term.

Hurley also represents "Jane Roe," a Cincinnati-area girl molested by her 21-year-old soccer coach, who in November 2004 accompanied her to a Planned Parenthood Southwest Ohio clinic where she had an abortion without her parents' knowledge at age 14 and used his credit card to pay for the procedure. A Planned Parenthood "Documentation Form for Suspected Sexual or Child Abuse Report" retrieved by Hurley as part of discovery in the lawsuit the girl filed in 2004 noted that the girl claimed to have been raped by a stranger but the clinic did not notify police of this serious felony charge because "due to physician-patient privilege, we are prohibited from reporting as no severe bodily injury was reported." Ohio prosecutors say there is no such exception to the state's sexual-abuse reporting law (if there were, there would be very few reports of abuse). Rachel Hutzel, the county prosecutor who secured Blanks's conviction, told the Cincinnati Enquirer in May that her office might look into criminal charges depending on what the girl's civil suit revealed. Another piece of paper retrieved by Hurley from the clinic during the discovery process is a note in a personnel-training file containing the words "don't ask, don't tell." Planned Parenthood has told news reporters that it has no idea where the note came from, and also that it had no idea that the man who paid for the girl's abortion might have had sexual relations with her. "When a 21- or 22-year-old man walks in with a 14-year-old girl and says they're brother and sister but they have different last names--there's no way that someone in that situation wouldn't know what was going on," Hurley said in a telephone interview. "When I tell this to people I know--and they're mostly pro-choice--they just shake their heads."

Also invoking the physician-patient privilege, Planned Parenthood Southwest Ohio is fighting tooth and nail via the appeals process a judge's order in the Jane Roe case that the organization turn over to Hurley its records of abortions performed on girls under 18 so that Hurley can review evidence of what he suspects is Planned Parenthood's pervasive underreporting of statutory rape and related crimes against minors (attorneys general in Kansas and Indiana are also fighting Planned Parenthood affiliates in court over similar files on underage abortions, with an eye to criminal investigations). Even if the names and addresses of individual patients are deleted (and Hurley says he has no interest in such information) and the files are never made part of the public court records, lawyers for Planned Parenthood insist that there are "profound and significant privacy issues," as one of them told the Enquirer. In late August, an appeals court sided with Planned Parenthood and overruled the trial judge; Hurley has asked the Supreme Court of Ohio to review the appeals court ruling.

Meanwhile, 18-year-old Lila Rose, a sophomore at the University of California at Los Angeles and founding editor of a pro-life student publication called the Advocate, listened to some of the Life Dynamics tapes on that organization's website earlier this year and decided to find out whether Planned Parenthood clinics were as seemingly cavalier about reporting sexual abuse in 2007 as they had been in 2002, when the organization had promised after the Life Dynamics revelations to train its staff more carefully. Armed with a concealed video camera, Rose visited two Planned Parenthood clinics, in East Hollywood and Santa Monica, and passed herself off as a 15-year-old seeking an abortion and a 22-year-old male friend who accompanied her as her 23-year-old boyfriend. She told staffers at both clinics that she didn't want her parents to find out about her relationship with the presumed 23-year-old. No employee at either clinic batted an eye at these revelations; the receptionist at the Santa Monica facility told Rose to say she was 16, because if she was 15, the clinic would have to make a report to the police. "Just figure out a birthday that works," the staffer advised.

Rose posted videos of the two clinic visits on YouTube on May 12. Two days later, she says, she received an emailed letter from Mary Jane Wagle, president of Planned Parenthood Los Angeles, demanding that she turn over the videotapes to Planned Parenthood immediately or face a civil lawsuit based on violations of a California law making it a crime to tape conversations without the consent of both parties. Although the law, like similar laws in many states, seems to contain an exemption for collecting evidence of crimes, Rose mailed the tapes to Planned Parenthood on the advice of lawyers from the Alliance Defense Fund, a pro-life legal aid organization that offered her free representation (not that Planned Parenthood's confiscation maneuver made much difference, because the videos had already been copied by fans and can be watched on YouTube to this day). "It's funny--Planned Parenthood went around saying that situations like the ones I encountered don't happen in 99 percent of the cases," Rose said in a telephone interview. "So I'm a very lucky person. At the first two clinics I went to, I got the 1 percent."

With incidents such as these surfacing at Planned Parenthood facilities, together with the organization's ever-increasing involvement in the abortion business, one might wonder why corporations that generally shy away from controversial causes and activities continue to donate to the organization. The answer is that, in increasing numbers, they don't, or at least they say they don't, which for public-relations purposes amounts to the same thing. An organization called Life Decisions International (based in Virginia and not connected to Life Dynamics) annually posts on its website the names of companies that, according to evidence the group says it has collected, donated to Planned Parenthood during the previous year; the aim is for pro-lifers to boycott the blacklisted businesses. Research for this story included contacting by telephone or email a cross-section of those Life Decisions-listed mega-corporations--Wachovia, Allstate Insurance, Sears Holding (parent of the Sears and Kmart retail stores), Marriott--expecting to hear, for example, praise for Planned Parenthood's teen-pregnancy prevention programs offered as justification for the corporate gifts. Instead, except for a couple of companies that ignored the calls and emails (notably the Walt Disney Co. but also Chevron), the uniform responses of the public-relations offices at the firms were either categorical denial or explanations that, as in the case of Wachovia, the donations in question had consisted of nugatory sums of a few hundred dollars given by a few distant local branches. Even such presumably "progressive" outfits as Adobe Systems and Whole Foods Market hastened to join the chorus of denials (a spokesman for Whole Foods said that a food tray or two might have been contributed by one of its stores to a Planned Parenthood-sponsored event). Apparently a significant portion of America's business world would rather not be seen as involved with the abortion industry, even when Planned Parenthood's activities are benignly "framed" (to use the word of former president Gloria Feldt) as merely making birth control more widely available to American women.

Indeed, there is some evidence that the $212.2 million in private contributions reported by Planned Parenthood for its 2005-06 fiscal year might be an exaggeration. For fiscal 2004-05, Planned Parenthood reported $215.8 million in income from private donations and bequests. That same year, about $61.8 million in "private support" to Planned Parenthood was calculated by the Chronicle of Philanthropy, on the basis of information supplied by Planned Parenthood to the Internal Revenue Service. Asked what could account for such a large discrepancy, Noelle Barton, a Chronicle editor who helped compile the report on the finances of America's largest charities, said, "They could be counting income from investing previous donations." Planned Parenthood's balance sheet contains no separate entry for investment income.

In any event, it is likely that the bulk of Planned Parenthood's private-source income now comes from ideologically commited pro-choice individuals, family foundations such as Rockefeller and Gates that answer to no one except their founders and/or boards, and other nonprofits untroubled by the organization's increasing abortion market share. One of the last is the breast-cancer charity Susan G. Komen for the Cure, whose affiliates give substantial grants to Planned Parenthood for breast-cancer screening ($712,000 for the 2006 fiscal year), even though the number of such screenings, like the number of other cancer screenings performed at Planned Parenthood clinics, has been in fairly steady decline (1.1 million breast exams in 2002-03; 844,201 in 2005-06).

With both clinic revenues and private-source income down, Planned Parenthood does still have one reliable source of funds to take up the slack: taxpayers. The $305.1 million in "government grants and contracts" the organization took in last fiscal year represented a 12 percent increase over the $272.7 million it received during fiscal 2004-05. Slightly under half of the $120 million-plus supplied by the federal government (states and localities, especially politically liberal states such as New York and California, make up the rest) came in the form of subsidies for free birth control under Title X. Title X was a panic bipartisan measure passed by Congress in 1970 in the middle of the "population bomb" scare, when many lawmakers believed that the only way to prevent the United States from running out of food by the year 2000 was to distribute free contraceptives as widely as possible to women and girls ages 15-44 in "low-income families."

Title X officially expired in September 1985, but Congress has continued to appropriate money for it in ever-increasing amounts. Regulations issued by the Department of Health and Human Services require the contraception distribution to be strictly confidential (i.e., no notification of the parents of minor recipients), and define a "family" so as to include "unemancipated minors" desiring contraceptives without their parents' finding out; according to the HHS regulations, they "must be considered on the basis of their own resources." That means the Hilton sisters could have qualified for free Title X birth control during their teen years had their allowances been short enough. About 14 percent of Title X recipients are girls under 18, according to a 2004 report from the program's grantees. On an Internet discussion website, a teenager boasts of making monthly visits to pick up her free birth control pills at Planned Parenthood Pasadena while wearing her Catholic school uniform. There is only one Catholic girls' high school in Pasadena, an affluent suburb of Los Angeles: the Mayfield Senior School. Tuition is $17,000 a year.

The other big federal program, channeling at least $61 million a year to Planned Parenthood, is known as "Medicaid waivers." The one thing to be said for the waivers, which also provide free birth control, is that it is harder for students at exclusive prep schools to qualify. The waiver program began in 1993, the first year of Bill Clinton's administration, when the Department of Health and Human Services decided to "waive," or relax, its usual income limits for qualifying for Medicaid benefits so that somewhat higher-income women (anywhere from 185 to 200 percent of the official poverty level) in participating states could receive free contraceptives. Furthermore, under the waiver program, in which 19 states currently participate, the federal government picks up 90 percent of the contraceptive tab, with states contributing only 10 percent--in contrast to ordinary Medicaid, where the federal-state split is more like 60-40.

Since Medicaid, unlike Title X, is an open-ended entitlement program not dependent on congressional appropriations for funding, the Bush administration has been trying to put a lid on the waiver program's burgeoning expense, signaling, for example, that it would not renew waivers unless states provided more medical services besides birth control to participating women--which states have been reluctant to do, because that would cost them money. When Hillary Clinton referred in her July Planned Parenthood appearance to Bush's "antiprevention" agenda, she was probably referring in part to Medicaid waivers. Clinton is cosponsoring a bill that would make the program (with the federal government paying 90 percent) a permanent and automatic component of Medicaid in every state without need for waiver applications or HHS approval--that is, expand it exponentially. That would be a bonanza for Planned Parenthood.

Whether the federal government ought to be in the business of subsidizing birth control, which, except in cases of rape or abuse, is a matter of individual voluntary decisions about one's sex life and desire for children, is a good question. Whether people should have an automatic "right" to subsidized birth control under Medicaid, to be paid for indefinitely out of other people's federal taxes, is another good question. Those are matters for a long-term policy debate. The more pressing question is whether the federal government should continue to subsidize, to the tune of tens of millions of taxpayer dollars a year, an organization, the Planned Parenthood Federation of America, that derives a heap of its revenues from abortions, has sustained a demonstrably poor record on reporting suspected sex crimes against underage teenagers--and has a mountain of cash to boot. What about the taxpayers' right to choose?

Charlotte Allen, a writer in Washington, is the author, most recently, of The Human Christ.