The battle over Planned Parenthood’s federal funding heated up in March. First, Speaker Paul Ryan introduced the American Care Act, which included a provision to defund the healthcare provider for one year. Six days after it failed to receive enough support, Mike Pence cast a tie-breaking vote to reverse an Obama administration action that prohibited states from withholding funding from Planned Parenthood clinics.

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If President Donald Trump signs the bill as expected, millions of women who benefit from its low-cost health services would have a big hurdle to overcome. Where would they go to get Pap smears, breast exams and safe ways to prevent unintended pregnancies at such a cost?

Dr. Seth Plancher, an ob-gyn at Garden City Obstetrics and Gynecology, spoke with Pulse about health insurance struggles and what the downside of losing Planned Parenthood on Long Island would be.

What are some alternatives for health care services for women on Long Island?
One of the big radiology centers on Long Island, it’s called Zwanger-Pesiri—they do free mammograms, we take advantage of that quite a bit… That’s what we do when our patients come in and they have no insurance and they need to have imaging… With respect to Pap smears, there are two components to that. It’s doing the Pap smear, but then someone of course needs to read that. Doctors don’t read them; they actually go to a lab for that. If a patient comes in to see me and doesn’t have insurance and we do a Pap smear and we do it for free or for a reduced price we still need to have the lab reduce it as well… There are some labs that are willing to give patients significant discounts as well and have been really helpful. One of the labs that we use will do that for certain patients that have no insurance.

Is this common for hospitals to do, too?
Hospitals, no. Hospitals are less likely to do that… If someone has no insurance but is able to get onto Medicaid, then there’s lots of free clinics where they can have all of this done including all of their lab tests. If not, the hospitals take Medicaid and a lot of the hospital clinics will take Medicaid. So those patients are actually OK. The ones that might be in more trouble are the ones that don’t have insurance or lose their insurance or their insurance is too expensive.

So if someone wanted to pay out of pocket, how much would this run them?
If you were just to call a doctor or a big hospital and say, “How much does a mammogram cost or a Pap smear cost?” I think you might get a really, really high quote. But I know for me, and I’m sure that it’s not just me—there are many doctors that would almost never turn away a patient who needed help or needed a service done and didn’t have insurance, as long as they were honest about it… Maybe something would be very expensive, but someone who is paying out of pocket who is in need would be able to come in and have a greatly reduced price. I’m talking, you know, dollars.

There are many times when patients that we know, or have known for years, they may lose their insurance, and it’s often a temporary thing. Maybe they are in between jobs or maybe they are going on a significant other’s plan, but they are not there yet. So those are patients we strive to really maintain because at some point they’ll have insurance again… Or many times we’ve seen people for really no charge or minimal charges. It’s just time that we are giving up. It doesn’t cost me anything to see a patient…

Again, it’s something that a lot of us do. I don’t think it’s universal and it’s probably not a great solution if many, many people don’t have insurance, but the true emergency or the tweener type person (someone temporarily out of insurance), that would be something we could provide.

If more and more people started coming to you to be treated without insurance, would it start to become a burden for you? 
If so many people came in—we can’t see everybody for free, of course. But we could certainly give an affordable price if possible, or at least refer them to places that they can be seen like the hospital, some of the clinics. It’s not just Planned Parenthood.

So if a pregnant patient comes in and says, “Look, I have no insurance. I want to know if everything is OK.” We can do that and then find them an appropriate place where they can be seen that they might not be aware of. Or help them get emergency Medicaid.

So there’s also more clinics?
Yeah, there are several clinics that people can be seen. They are usually affiliated with the hospitals.

Do you know how the wait times compare at Planned Parenthood versus a private practice like yours?
That’s such an open ended question because I think it really depends on the practice… It’s so practice dependent, I’m not sure there’s an easy answer to that.

If Planned Parenthood were to get defunded, do you think wait times would increase at other clinics and private practices?
Yeah, I guess they would increase just because of the overflow of patients… That’s probably a good thought that if Planned Parenthood were to close then those patients have to go elsewhere and those other offices might be somewhat overloaded, at least initially. And one sequelae of that might be longer wait times.

What are your thoughts on the fears of defunding Planned Parenthood?
I think that a lot of it is somewhat political jargon. I don’t really necessarily see it happening; I certainly hope not… I’m hopeful that it doesn’t happen because, besides the more controversial parts of Planned Parenthood, they do provide healthcare for a lot of people and it certainly would be a big loss to Long Island if they were not around anymore.

A big loss for who?
For the community. All these people that are getting care there, they would need to find alternative places. I think that’s one of the things about Planned Parenthood is the name presence. People know it exists so if someone has an issue and they know they need to be seen they say, “Oh, I’ll go to Planned Parenthood.” You know it, you can Google it, you can look it up, you can find it. As opposed to saying “the clinic.” Well, where’s the clinic, right?… Ultimately I think that you could probably fill the gap but it wouldn’t be very easy.

Planned Parenthood’s federal funding has long been a subject of national debate. On Monday, a doctor compares the mental health ramifications of having an abortion vs. being denied an abortion.