NEW YORK — Dr. Leana Wen came on board last September as Planned Parenthood’s first physician CEO and president with a vision of transforming Planned Parenthood into a mainstream health-care provider that would offer abortion amid a host of comprehensive services. That, Wen believed, would secure Planned Parenthood’s long-term future.

Just eight months on the job, Planned Parenthood’s two boards — Planned Parenthood Federation of America and the Planned Parenthood Action Fund — met July 16 in an emergency session and voted to terminate her leadership. After she refused to resign, Wen was fired that same day.

Her sudden departure revealed Planned Parenthood’s deep, internal divisions between those who believe the abortion provider is a health-care organization and those who believe Planned Parenthood’s mission is primarily to advocate for abortion. The boards’ emergency meeting — held just one day after the Ninth U.S. Circuit Court of Appeals upheld the Protect Life Rule — showed abortion activists have won the day within Planned Parenthood. Wen cited these “philosophical differences” in a memo she sent to colleagues, which she also published on her Twitter feed.

“The new board leadership has determined that the priority of Planned Parenthood moving forward is to double down on abortion-rights advocacy,” she said.

In a New York Times op-ed, Wen explained her strategy was to make Planned Parenthood a comprehensive health-care provider that would provide low-income women with “full spectrum care” that would both normalize abortion as health care and politically protect abortion for the long term.

However, she said her health-care team faced “daily internal opposition from those who saw my goals as mission creep” and that her efforts to build bridges with those outside progressive political circles also came under fire.

“There was even more criticism as we worked to change the perception that Planned Parenthood was just a progressive political entity and show that it was first and foremost a mainstream health-care organization,” she said.

But Wen’s ouster at Planned Parenthood takes place at a time when Planned Parenthood is both more powerful than it has ever been in its history and when its challenges — including its fear that the 1973 Roe v. Wade decision legalizing abortion could be repealed — are increasing.

 

Power and Challenges

The New York Times confirmed Planned Parenthood employees were frustrated about her promotion of non-abortion health-care services but also felt that they were losing because Wen was too slow to respond to attacks on legal abortion. The final straw seemed to be Wen’s July 6 op-ed about her recent miscarriage of a child she desperately wanted; the paper reported Planned Parenthood’s boards felt caught off-guard, and so decided to convene a secret meeting to remove Wen on July 16.  

Wen’s removal following the Ninth Circuit Court of Appeals upholding the Trump administration’s Protect Life Rule, which bars Title X family-planning funds from going to health providers that provide or refer for abortions, also significantly underscored Planned Parenthood’s alarm. The federal appeals court was renowned for issuing decisions that favored liberal policies, but court watchers say Trump has been reshaping the court, and it no longer leans so far left. In fact, the president is expected to reshape 40% of the federal judiciary with nominations by 2024.

“Planned Parenthood recognized what a momentous time this is,” Catherine Foster, president of Americans United for Life, told the Register. The abortion giant has been anticipating a post-Roe future by lobbying aggressively at the state level to either expand abortion access or stonewall attempts in other states to limit it by the passage of aggressive pro-life legislation such as six-week abortion bans along with other legislation meant to restrict abortion.

Foster agreed Wen’s removal did come down to “how political she was or wasn’t.”

“Abortion as part of health care is not what they wanted.”

 

Defending Medicaid

The amount of Title X money at stake for Planned Parenthood is ballparked at $60 million. But losing the court battle to retain that funding, while Wen was in charge of the organization, may be more significant than that: The decision may have put other major sources of revenue at stake by damaging Planned Parenthood’s aura of political and legal invincibility and spurring pro-life organizations to look at ways to target the rest of the half-billion dollars in federal government money it receives each year.

“Five years ago, they probably thought there is no way the Title X money could get lost,” Ben Clapper, the executive director of Louisiana Right to Life, told the Register.

Robert Warren, a research associate at The Catholic University of America’s Busch School of Business and a retired IRS investigator, told the Register that according to the audits conducted by KPMG and IRS tax returns, Planned Parenthood has never been stronger financially. Although the financials do not reflect Wen’s brief tenure, Planned Parenthood has massive reserves in the bank.

Tax forms for fiscal year 2018 showed its current assets went up from $844 million to $1.04 billion.

The organization’s total revenues totaled $1.665 billion in 2018, and once all its expenses were paid, it had $244.8 million leftover to add to its already massive reserves.

While Planned Parenthood makes money from performing abortions, Warren said its greatest source of income is advocacy of abortion. He pointed out that Planned Parenthood raised $532.7 million in 2017 and $630.8 million in 2018 from private contributions raised primarily by calling on people to support them as the champion of abortion in the United States.

Warren said Wen’s approach was de-emphasizing their main moneymaker, abortion.

Amid Planned Parenthood’s declining number of people seeking their health services, the one exception is abortion.

That figure went up 3% in 2018 over the previous year to nearly 333,000 abortion services.

Warren explained Planned Parenthood’s “double down” on abortion advocacy by firing Dr. Wen is intended to protect both its main revenue sources: its standing as the No. 1 political advocate for abortion and the half-billion dollars in government funding that comes mostly in the form of Medicaid reimbursements.

“They could really be in trouble [from losing the Title X fight],” he said, “because that may set the precedent to take away their federal funding from Medicaid.” He pointed out that Planned Parenthood’s financials show their facilities get nearly a third of their revenue from Medicaid.

 

Not the First Time

Wen’s firing by Planned Parenthood, however, is the second time that Planned Parenthood has hired a medical professional only to fire the new hire within a year for prioritizing health services above abortion advocacy. “It makes you wonder why they repeated the mistake they thought they made in the 1990s,” said Chuck Donovan, the president of the Charlotte Lozier Institute, a pro-life research think tank based in Washington, D.C.

 

Pamela Maraldo’s Ouster

Donovan said a similar situation happened with Pamela Maraldo, a nurse who became Planned Parenthood’s CEO only to be ousted in 1995, after two years, because she thought Planned Parenthood should become a comprehensive health-care provider that also did abortions.

Donovan explained that Maraldo was trying to position Planned Parenthood for long-term survival as the Clinton administration was pushing health-care reform when she was jettisoned for not emphasizing abortion advocacy enough.

In a July 20  interview with NPR, Maraldo explained that two schools of thought exist in Planned Parenthood. The one she and Wen adopted is that strategically placing abortion in the broader context of health care would mitigate attacks on legal abortion in the long run; the other school of thought holds Planned Parenthood as primarily an organization to advocate for abortion.

Maraldo said it was the right call to hire Wen, “because at the end of the day, if [Planned Parenthood] weren’t a health-care delivery network, they would be NARAL,” referencing the abortion lobby group NARAL Pro-Choice America.

But NARAL cannot compete with the financial and political heft of Planned Parenthood; according to tax information filed with the IRS, NARAL currently has less than 10% of the cash and cash assets held by Planned Parenthood.

Abby Johnson, former Planned Parenthood director-turned-pro-life advocate, said Wen’s hiring was a surprising act to follow Cecile Richards, a veteran activist with renowned political instincts. But Wen had the credibility of a medical professional, as well as some abortion activist bona fides, as she had fought crisis-pregnancy centers as the public health commissioner in Baltimore.

Johnson said Wen, as a medical professional herself, would have seen where Planned Parenthood’s standards were not up to par and noted that her earliest statements about prioritizing women’s health care set a “different tone and direction” than Richards. Many of her activist statements, Johnson noted, also sounded a bit forced.

 

Pushing the Mission

But Johnson said Planned Parenthood realized this year it actually needed an activist “to push their mission forward.”

Planned Parenthood’s board members may have thought they were getting an activist who was a doctor, not a doctor who was also an activist.

“It turned out that Wen was a doctor first, and I think that was disappointing for them.”

Indeed, abortion activists have a majority control of Planned Parenthood’s two boards of directors. And, according to Donovan, the selection of board member Alexis McGill Johnson, herself an experienced activist, as interim president and CEO for Planned Parenthood while the board searches for a more politically minded successor, is another clear signal that Planned Parenthood realizes that it “chose the wrong leader” by selecting Wen at an especially sensitive political moment.

Said Donovan, “This is somebody who knows correctly the 2020 election is a national referendum on abortion.”

Peter Jesserer Smith is a Register staff writer.