Facing a blitz of government attacks

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ALEXIS McGILL JOHNSON: At every level of government, we are under attack. They’re coming for us even when they know it’s not popular. I know it’s hard for corporations to take a stand in this moment. I think that clearly has been a strategy from this administration, but I urge them to consider the ways in which where they are operating are also being impacted, and how their workers are being impacted. Your values, that’s your integrity. That’s who you are. And so I cannot actually stand here as the president of Planned Parenthood, and say, “We’re going to walk away from the very communities that we have committed ourselves to providing care for.”

BOB SAFIAN: That’s Alexis McGill Johnson, president and CEO of Planned Parenthood. Alexis appeared as a guest on this show in 2022 after the U.S. Supreme Court removed the federal right to abortion, and she talked about adjusting strategy in a worst that could happen moment. I wanted to have her back today because in 2025, she faces another existential challenge targeting Planned Parenthood’s funding. She’s back in front of the Supreme Court this time asking for relief from an attack by South Carolina’s governor while cases in other states like Texas are brewing. The day after we spoke, the Trump Administration said it would suspend funding for nine Planned Parenthood affiliates under the family planning program known as Title 10. Alexis’ reaction to all this is, as she puts it, to play both defense and offense, including going after The New York Times.

Whatever your political leaning or your position on abortion, Alexis’ approach to conflict, how she motivates herself and her team, it provides a telling window into leadership in duress. I’m Bob Safian, and this is Rapid Response.

[THEME MUSIC]

I’m Bob Safian. I’m here with Alexis McGill Johnson, president and CEO of Planned Parenthood. Alexis, welcome back to the show.

JOHNSON: Thank you so much for having me, Bob. What times we’re in.

Copy LinkFacing new legal battles at Planned Parenthood

SAFIAN: Yes, Planned Parenthood is at yet another inflection point. We’ve talked previously about the Dobbs case, the Supreme Court decision that allowed states to ban abortions. With the election of Donald Trump, there’s a new wave of challenges, particularly around funding for Planned Parenthood. This week, you’re back in front of the Supreme Court for oral arguments over South Carolina’s efforts to block Medicaid coverage of Planned Parenthood health centers. How uneasy is that? You haven’t had much luck with the Supreme Court recently.

JOHNSON: Well, what can I say, Bob? I mean they’re coming at all sides, from all sides, from a whole of administration approach to trying to take away healthcare for millions of people in this country. You are right at every level government. We are under attack, and I do think that this Trump era, this new Trump era 2.0, is different, because they have consolidated power in every single branch, and they are using it with abandon, and watching them try, whether it’s a Medicaid defund, a Title 10 defund, potentially the Supreme Court case that could deny us access to Medicaid state by state, it just feels like everywhere we turn, they’re coming for us even when they know it’s not popular.

Copy LinkThe role of Medicaid in Planned Parenthood’s operations

SAFIAN: Planned Parenthood’s known for its policy advocacy, but it operates 600 some health centers around the country providing care beyond just abortion services. The South Carolina case that is this week, it has this sort of potentially massive implications for that work. I mean, something like half of the patients at Planned Parenthood centers use Medicaid, so this is sort of a way to shut down the flow of resources.

JOHNSON: Yes, and you’re absolutely correct. I mean, first of all, just to level set who Planned Parenthood is, Planned Parenthood is first and foremost a healthcare provider, providing millions of patients access to basic STI testing, and family planning, everything that you could imagine with respect to sexual and reproductive healthcare, and 50% of our patients are also Medicaid patients. Over 60% of our patients are in rural areas. This Supreme Court case, Medina versus Planned Parenthood of South Atlantic is really about Governor McMaster, the governor of South Carolina, trying to insert his own opinion in order to deny South Carolinians the right to choose Planned Parenthood as a provider.

Denying South Carolinians who use Medicaid from using that insurance at a Planned Parenthood, it means he would deny Planned Parenthood patients the right to choose their own doctor. It is so anti-freedom, is so anti-choice, is anti-libertarian, so anti-conservative government, but it is about power, and control, and trying to deny us access to care. The concern here is not only about the South Carolinians; it’s that this is a national case where other states could in fact follow McMaster’s lead if the Supreme Court gives them a go-ahead, and they could similarly try to deny access to Medicaid for Planned Parenthood patients.

SAFIAN: And it’s not specifically Medicaid that is being spent on abortions.

JOHNSON: Right, because Medicaid isn’t being spent on abortions because of the Hyde Amendment, thank you for that layup, Bob, because Congress already has an amendment to most bills where federal tax dollars are not being spent on abortion services. This is about denying access to birth control, STI testings to breast cancer screenings, to wellness exams, just your basic average healthcare that virtually every woman, one out of three women comes to a Planned Parenthood, has been to a Planned Parenthood in their lifetime, so a very significant reach, in terms of who we see, and who we serve, and it’s trying to deny them access to choosing who their doctor should be.

Copy LinkDefending health equity & DEI in challenging times

SAFIAN: And these attacks on Planned Parenthood, you say they’re coming from all places. I mean, I know there’s a Medicaid fraud suit in Texas trying to get two billion in restitution. There are these sort of DOGE efforts to quote defund Planned Parenthood. I know there were rallies in DC last week by anti-abortion groups. You’re kind of getting it from all sides. How do you manage that noise, that attack? How do you not just be reactive?

JOHNSON: First of all, at Planned Parenthood, we’re used to being under attack, right? Because the very healthcare that we provide has been so politicized, it’s been so stigmatized, and subject to political football at all turns, even though the majority of Americans support the care that we provide, and receive the kind of care that we provide, but it is Planned Parenthood that is always under attack in these cases. So, we are used to the onslaught, we’re used to the state-by-state fights. We are used to congressional attempts at defunding us through Medicaid, and obviously the Supreme Court cases. So, we are used to that, that defensive strategy. I think obviously, as you pointed out, the onslaught feels different this time because it feels very coordinated in terms of the all-hands kind of on-deck attack towards us. But we are also on offense, right? We have own kind of litigation docket of 30-plus cases where we are suing in states like Missouri, where the voters of Missouri went to the ballot last year, and the first state within abortion ban was able to flip that ban so they could provide access to abortion.

And so we are also playing offense to ensure that we can provide wherever we can, and we’re also thinking just about the care system, right? About what do we need to do to maximize our ability to see patients in this moment? It is a difficult time for all healthcare systems. I mean, we’re watching folks like Walgreens get out of the online care business, and Amazon make fundamental different choices after they’ve invested millions of dollars into standing up healthcare systems, and seeing how hard it is because the cost of healthcare continues to rise. Planned Parenthood is more popular than this administration. It’s more popular than any elected official. You always have to have a good offense with your defense.

SAFIAN: For a lot of the business leaders who are listening to this, they may not be under quite the attack that you guys are, but it does feel like so much is changing in ways that make them rethink some of their priorities. I mean, I know you guys have come into the crosshairs of the administration about DEI reportedly freezing funding over compliance questions. I know you’ve been an advocate for corporate DEI for years. You co-created Starbucks’ racial bias curriculum in ’18. Are you disheartened about how the business world is responding to some of these other things to the DEI rollback? Are there just so many other fights for Planned Parenthood that some things you just have to let go?

JOHNSON: No. You know what? I think that the weaponization of DEI, which is essentially about just ensuring that all your people are seen, that they all have the right conditions to do the incredible work that you want to do to inspire them, that they are included in every way, and supported so that they can make your business the best. It’s really always, DEI is always been about strategic business sense, and we’re watching administration try to deny business and corporate American universities the tools that actually do make America great. I look at who comes to a Planned Parenthood health center — that includes Black, brown, white communities, rural, urban. It includes folks from all parties, and ideologies. Some of the same people who are out protesting Planned Parenthood on any given Tuesday are coming into the clinic on any given Wednesday to get access to care.

And so I think that we are a big tent, to be honest, and that we are very well-served by our ability to provide care that is nonjudgmental, and so at the end of the day, they can come, and they can attack on DEI, but I’m very clear that that is just a caricature of what that work really is. It really is about creating the right sense of welcoming, and belonging, which most Americans again support.

SAFIAN: Yeah, and so you’re not rethinking DEI policies within Planned Parenthood. You’re not necessarily rethinking, I don’t know, transgender care, which is something that the Trump Administration has attacked. Your supporters who back sexual and reproductive care align on gender-affirming care, on DEI. You’re all in on all of these things.

JOHNSON: Well, as a federation, we come together to think about what our long range goals are. The national office, our 49 affiliates, our membership essentially gather every few years to kind of recommit ourselves to say, “What do we need to accomplish in the next few years?” And for the last two long-range goals, we have said that health equity is our North Star, and what do we mean by equity? I think some of the challenge here is that we use words like DEI without actually interrogating what those words really mean. And so when I say health equity, I’m really talking about health outcomes no matter where you live, no matter what zip code, no matter who you are, no matter, again, any other way in which you define yourself, or categorize yourself that you are able to get the access to the care that you need.

And our job is to ensure that in every community, we are reducing the disparities, because where you live shouldn’t be a barrier to what kind of healthcare or health outcome you should have, and that goes for gender-affirming care. We obviously are going to stand with our trans community because we see them, we understand what their needs are, and I think that it’s incredibly important in these moments when people are trying to demonize communities, pick communities against each other, that they know that they’re going to have one backer there to say, “We are going to stand with you no matter what.”

Copy LinkThe importance of steadfast values in corporate strategy

SAFIAN: I mean, I ask these questions in part because the administration strategy sometimes seems like they want to flood the zone with so much to sort of push opponents, push organizations, corporate organizations, to kind of give up on something in order to protect a higher priority, right? Do you feel any of that pressure to prioritize in a different way in this environment?

JOHNSON: I can say I feel disappointment. I feel concern that a number of really critical institutions in our society, the very institutions that kind of make up our demos, that make up our civic education and learning environment, that make up the backbone of our jurisprudence and legal foundations. Corporations are feeling a financial pressure to, I think, in many ways go against their core values. There may be lots of ways in which they’re reconciling that. I know as a leader that your values are, that’s your integrity, that’s who you are. And so I cannot actually stand here as the president of Planned Parenthood, and say, “We’re going to walk away from the very communities that we have committed ourselves to providing care for just because the administration may be a little bit easier on me.”

It goes very much against what Planned Parenthood stands for, and how we were founded. We were founded by providing birth control, which at the time was not actually legal. We were literally born into resistance. And I do think that resistance word is a little funny these days, but when you are providing care that has been stigmatized, that in itself is an act of resistance, and that’s how we have to stay grounded in our mission.

SAFIAN: It sounds like you wish maybe that there was a little more bravery from some other leaders whose, I don’t know, missions may not be as clearly values-based all the time.

JOHNSON: Two things come to mind here. One is watching people obey in advance, right? Comply in advance before the actual directives come, which I think sends a signal that people are willing to kind of stand down, but I think we’re also missing the collective action here, that there is a logic of collective action that means that when we actually stay kind of arms-linked, and say, “You know what? We are going to stand with the rule of law, and what we believe the constitution says here.” And so I think it really is about linking arms, and understanding that that is really the kind of strongest attack back in some ways to the kinds of things that we are facing.

SAFIAN: And you wish there were a little bit more of that linking arms, or you’re hopeful it will emerge?

JOHNSON: I think when you can pick off one organization, or one law firm, or one university, and set them out as an example, it makes it harder for other people to link arms and come together, and I think we’re seeing people learn that and try to course correct. I hope so. But I know that Planned Parenthood is standing very strongly with other organizations that are prominently defending free speech, prominently fighting for care in the face of, again, not just a Medicaid defund. We’re talking about gutting the NIH and the CDC. We’re talking about the government layoffs of tens of thousands of workers. When I think being able to stand with the people who are most impacted is actually the strongest stance.

SAFIAN: The financial pressure that Alexis is facing from government players is unprecedented, but Planned Parenthood isn’t alone in that these days. Alexis cites other businesses that quote, obey in advance, which she sees as the wrong kind of playing defense. As for playing offense, one of her targets has been The New York Times. We’ll talk about that, and more after the break. Stay with us.

[THEME MUSIC]

Before the break, Planned Parenthood’s, Alexis McGill Johnson talked about the onslaught of government attacks it’s facing from South Carolina to Texas to the White House. Now she explains her own attack against The New York Times, the physical threats that Planned Parenthood team members continue to face, and her impassioned case for business leaders to stand up for their values. Let’s get back to it.

Copy LinkReacting to a NYT article about the quality of care at Planned Parenthood

I have to ask you about a front-page New York Times article that ran recently accusing some Planned Parenthood centers of poor quality care and low morale. Your reaction to it was to call it an irresponsible piece of journalism. I have to ask you, are you saying The New York Times is fake news? It sounds a bit like Donald Trump.

JOHNSON: I did think it was an irresponsible piece, and I do think that to cherry-pick five examples of service when Planned Parenthood health centers provide nine million bits of service, I thought it was irresponsible. I do think that the challenge here is that it was lacking a lot of context around what is happening in healthcare broadly, the increased costs that we’ve seen since COVID of healthcare workers, of insurance costs, of getting access to supplies, all sorts of things, again, that every other health system is experiencing in this moment. I’ve been to some of the finest hospitals in this country, and they’re also not immune to challenges with respect to providing healthcare. It’s a very difficult business, and the fact that if something happens to Planned Parenthood, it’s not like any of these health systems are vying to come in and provide support for low-income communities that rely largely on government insurance in order to get the care.

I think those things were missing, and we are not the government, so the resources that we get from something like Medicaid have to be subsidized as well by charity, because the government has not fully funded sexual and reproductive healthcare. I thought they could have talked about the gender bias in reimbursements, right? Why is it that reimbursement rates have not been improved in many states for the last 17 to 20 years as it relates to gender? And if you think about it, when any kind of care is attacked, and stigmatized, and banished, and criminalized, in fact, you have to think about just all of the other things that have to wrap around in order to do that. So, I stand by the quality of care, Bob, 100%, and I recognize that there are always going to be points in any healthcare system where it doesn’t rise to the level of standard that we hope to see, but there are always places where we are going to learn from, and improve upon.

SAFIAN: Now, I feel compelled as a journalist to push back in support of other journalists, but I hear you. I mean, it is something that we sometimes do where we’ll use a well-known organization to illuminate a point without necessarily recognizing or acknowledging this is happening in lots of places. Planned Parenthood is one of the places where this may occasionally happen, but why focus it just on Planned Parenthood as opposed to looking at the broader issue? Am I interpreting all that the right way?

JOHNSON: That’s the question. That is absolutely the question. And look, I have utmost respect for The New York Times and for the journalists. This is where I disagree: There was no story that was not about Planned Parenthood. If it was just about a story about healthcare systems being challenged in the rising costs, why have CVS, and Walgreens, and Amazon left sectors of their healthcare business? What does that mean for them to leave it? It could have been that story, but I think that there was, and there has been, just based on the questions I have gotten alone since the Dobbs decision, questions about how Planned Parenthood will survive in this moment, and almost as if people are looking for failures at Planned Parenthood in order to make a case rather than look at the broader impact of the Dobbs decision, and how we got here, and the systematic decisions that were made by the Trump Administration installing these Supreme Court justices and these state legislatures across the country that are denying women access to getting the basic healthcare that they need. So, it’s not a story about how we got here and the impact of that. It is a laser focus on whether or not Planned Parenthood will survive, and I do question that as a journalistic choice.

Copy LinkNavigating threats to team members and patients

SAFIAN: I mean, Planned Parenthood is, as we’ve said, under constant attack, sometimes metaphorically, sometimes financially, sometimes physically. Do you feel like you’re personally under attack, and, sort of, what’s the mood and morale for your team?

JOHNSON: The Planned Parenthood health center workers who walk through protesters, who walk through probably more protesters now, given that the Trump essentially gave immunity to several of those protesters who had been arrested under the Face Act, and allow them to essentially come back to harassing our workers, I’m worried about them. I’m worried about the patients who have to navigate that. I’m worried about the abortion providers who are day in, day out, sometimes traveling hundreds of miles back and forth between cities and affiliates in order to ensure that everyone can meet the need. I think for my team, we center them, and we ensure that they have what they need. I chose this fight. You don’t come to Planned Parenthood by accident. I don’t worry about myself. I worry about supporting all of the people who show up every day because they care about this mission.

SAFIAN: You have days though, sometimes you’re like, “All right, I signed up for this fight, but this fight has become harder, and harder, and harder, and I’ve been in this fight, and maybe it’s time to just make my life a little easier.”

JOHNSON: Well, I mean, there are always days, but I think sometimes, and I think this is a particular kind of leadership, where sometimes you see a fight, and you want in on it, and I think you can’t do this job unless you relish taking on the fight because you really believe in the cause. And so are there days where I’m tired? Are there days where I think I can’t get on another plane, or I’m trying to balance a lot with my family, and make sure I’m back for the high school musical? Those are the sorts of things that every executive is making a choice on, but I can tell you what does pull me through, and that is those moments when I am sitting on a plane, and someone comes up, and they say, “Thank you for doing what you’re doing.” They may grab my hand a little tighter. They may look me in the eyes. They may tell me their whole story.

Being able to bear witness to the difference that Planned Parenthood has made in their lives, I think is something different than what a lot of CEOs may experience in their day-to-day. And so it is grueling. I won’t lie on that regard, but it really means something. This is just an honor. I don’t know how to top this. It will be an honor to have served in this role.

Copy LinkAddressing the national public healthcare crisis

SAFIAN: Well, Alexis, I always appreciate you being willing to take my questions and delve into some of your feelings about this. Is there anything that I didn’t ask you about that I should have?

JOHNSON: I’m just going to cut back to the patients, Bob. I mean, is the patient stupid, right? We should be asking questions about how as a nation, we are going to address this public healthcare crisis, and what are we going to do to stop the kind of attacks on communities that can least afford them. This attack on Medicaid, this attack on Title 10, whether that is through the Supreme Court, or through Congress, or through executive action — these are the kinds of things that are actually harming real people, and I just urge all of us, including our business leaders, where they are sitting, and I know it’s hard for corporations to take a stand in this moment. I think that clearly has been a strategy from this administration, but I urge them to consider the ways in which where they are operating are also being impacted, and how their workers are being impacted.

The first year after Dobbs, there was a 10% decline in OBGYNs matching into banned states. The second year after Dobbs was a 20% decline in states like Alabama, Texas. We have seen how abortion bans have made pregnancy more dangerous. When I’m talking to young executives, young people coming out of B-School, women who have risen the corporate ladder, that’s the thing that they bring back to me. They talk about the difficulty in making those choices of relocating to states. What is it going to mean for me to raise a family here if I can’t get the high-risk OB care that I may need? How am I going to do that? I can’t fly across the country when I have a miscarriage. That makes no sense. And so I do think that there is still a very compelling, important business interest.

We’re not talking about it in the same way as we have in the last couple of years, but I would encourage leaders to engage in their communities with their state legislatures, with their Chambers of Commerce to kind of raise issues around the quality of community that I think is going to continue to impact our economy. It’s going to impact where students are choosing to go to school, where they choose to leave school, and come to work. It’s already happening in the medical profession, and that trickle down is going to be very dangerous.

SAFIAN: Well, Alexis, thank you for being here, and sharing, and for putting up the good fight.

JOHNSON: Thanks, Bob. Good to see you.

SAFIAN: Few business leaders endure more attacks, and hostility than Alexis. When she was on this show three years ago, you could feel her willing herself to be positive. The revoking of Roe V. Wade by the Supreme Court had clearly taken an emotional toll. Yet today, even though the situation is in many ways more dire, she seems even more resilient. Her embrace of Planned Parenthood’s mission is fueling her through the storm. For any business leader in crisis, there’s a critical lesson in that, and as Alexis encourages a model for bravery and defiance in the face of conflict, and uncertainty, I hope you find reasons for hope from listening to this episode.

Our work problems may not always match the drama of Planned Parenthood, but if workers in the hot seat can stay true to their ideals and principles in the face of historic challenges, why shouldn’t we? I’m Bob Safian. Thanks for listening.