Health centers across New England expand services related to menopause care, vasectomy and colposcopy.

by Emily Rodin, for the Community News Service

BURLINGTON — Abortion providers saw significant federal funding cuts last year with the passage of President Donald Trump’s One Big Beautiful Bill. The legislation barred certain abortion providers, including Planned Parenthood affiliates, from receiving Medicaid reimbursements for non-abortion care, leaving clinics across the country in financial crisis. 

The ban on Medicaid reimbursements expired last month, but the defunding took its toll. Nearly two-dozen Planned Parenthood health centers closed across the country, according to a March U.S. Senate report. Some affiliates on the West Coast survived by offering cosmetic procedures such as Botox injections.

For Planned Parenthood of Northern New England, which has health centers across Maine, New Hampshire and Vermont, planning ahead began well before the defunding became a reality. Clinics across the region are now offering expanded programs, many of which carry higher Medicaid reimbursement rates, as they look toward the future.

Nicole Clegg, president and CEO of Planned Parenthood of Northern New England, said the slate of services are “about making these patient-centered decisions” and protecting them “from the harm that Congress and Trump are trying to pass onto them.” 

“It’s been significant. There’s something every month that they’re doing to try and make it harder for us to provide health care,” Clegg said. 

Trump’s bill, which was signed on July 1, 2025, sent Planned Parenthood affiliates into a tailspin. At first, Planned Parenthood of Northern New England considered either changing the care available for patients covered by Medicaid or closing more health centers, Vermont Public reported last year. 

Even so, the affiliate had long been preparing for the worst. 

“Because we had already gone through one Trump administration, we started to contingency-plan over the summer and into the fall before Trump was reelected so that we could really be prepared if and when events like the defunding happened,” Clegg said. 

Between 20 and 30 percent of Planned Parenthood of Northern New England patients are insured by Medicaid, which left a sizable revenue gap, Clegg said. The state continued to reimburse Planned Parenthood providers for its portion of Medicaid costs but couldn’t rely on federal funds to offset the remainder. 

Planned Parenthood of Northern New England said Vermont officials eventually agreed to chip in an additional $600,000 to help the organization get by. The Department of Vermont Health Access, which manages Medicaid reimbursements, didn’t respond to multiple requests for comment seeking details about the funding.

Eleven other states, including New York, Maine and Connecticut, also provided bridge funds for their local affiliates but with funding restrictions now expired, they will once again receive federal reimbursement for that care. 

As Planned Parenthood of Northern New England waited for Medicaid funding to resume, its clinics began offering increased access to menopause care, vasectomy and colposcopy services, all of which receive slightly better reimbursement rates than other services, Clegg said. 

They also help destigmatize certain sexual and reproductive health needs, Clegg said. 

Menopause, for instance, is widely misunderstood, to the degree that some people don’t believe perimenopause exists, said Katie Riley, the affiliate’s director of menopause services. Riley recently started a program to train providers how to better care for women as they age. 

“A lot of people don’t think of Planned Parenthood as a place that provides services for sexual and reproductive care across the lifespan,” Riley said. “I think we are just automatically so well positioned to provide this care, and I think our clinicians are so good and doing such a good job of providing it.”

The organization has also expanded its cancer screening offerings. Markie Van Orman, an advanced practicing clinician and certified nurse-midwife at the Burlington and Williston health centers, recently completed training in colposcopy. 

Often recommended after an abnormal Pap test, the procedure involves examining the cervix to identify any precancerous or cancerous abnormalities. Delaying or skipping a recommended colposcopy can increase the risk of cervical cancer.

Previously, there were only about two or three Vermont clinicians trained in colposcopy, requiring them to travel across the state a few times a month to provide care to patients, Van Orman said. With more providers now trained to perform the procedure, patients have access to care several days a week, shortening wait times and reducing the risk that patients forgo follow-up care. Van Orman performs up to 18 colposcopies per month.

“It’s not a new service, but it’s newly established in a way that’s very routine,” Van Orman said, though she acknowledged there are still gaps in care. 

“If we can kind of continue to expand to those more rural parts of the state or expand access for our kind of hubs like Burlington and other larger health centers, I think it’s always worth it,” Van Orman said.

Over the past year and a half, the organization has also expanded vasectomy services at health centers across New England, beginning with its Burlington location, and plans to add two more sites in the near future, Clegg said. 

The service matches demand. A recent American Medical Association article found that vasectomy rates have increased by 26% in the past decade. 

“The fact that our appointments are filling up, and they’re filling up into the fall at this point, really speaks to the fact that there was a gap here,” Clegg said. 

Across Lake Champlain, northern New York affiliates have been offering all three services — menopause care, vasectomy and colposcopy — since 2022, but have struggled to expand them in the current fiscal environment, said Crystal Collette, president and CEO of Planned Parenthood of the North Country New York. 

“It’s a tough balance for a small, rural organization to make sure that we are maintaining stability but also keeping our eye on the future,” Collette said. 

Recruiting and retaining clinicians remains one of the affiliate’s biggest challenges, Collette said. Because of this, the organization increased salaries over the past year and hopes to address patient demands further as staffing improves. 

“We are an incredibly resilient organization,” Collette said. “We can be scrappy when we need to be scrappy, we can be creative, we have people who care deeply about what we do.” 

Emily Rodin is an intern for UVM’s Community News Service through Report for America’s Local News Internship Program.