Marquette, Michigan — On the final day of patient care at Planned Parenthood’s Marquette clinic, dozens gathered outside with pink homemade signs reading “Thank You!” and “Forever Grateful.” The clinic, the only provider of abortion services in Michigan’s Upper Peninsula, is closing due to financial challenges, leaving a five-hour drive as the next closest Planned Parenthood location for the approximately 1,100 annual patients.
Growing Trend of Clinic Closures in States Protecting Abortion
Despite abortion remaining legal in states like Michigan and Illinois, at least 34 clinics have closed since last year—17 in 2024 alone—according to ineedana.com data. Experts point to financial and operational pressures, rather than legal restrictions, as the key threat to abortion access in these states.
“These states that we have touted as the best versions of reproductive justice are struggling,” said Erin Grant, co-executive director of the Abortion Care Network. Rising costs, increased operational risks, and demands on providers to be activists, lobbyists, and caretakers are stretching resources thin.
Financial Strain and Policy Uncertainty
Clinic operators face several compounding pressures:
- Rising operational costs and low insurance reimbursement rates.
- Growing demand for telehealth abortion services.
- Potential renewed exclusion from Title X federal funding under the Trump administration’s policies.
- Increased financial strain on abortion funds that help low-income patients pay for care.
Planned Parenthood of Michigan (PPMI) announced the closure of four smaller health centers, including Marquette, citing these financial pressures and the difficulty of sustaining smaller clinics. While medication abortion was offered, procedural abortion was not available at these locations.
PPMI CEO Paula Thornton Greear emphasized the difficult decisions and the goal of long-term sustainability, but staff and community members expressed frustration, especially given that executive pay has not been cut amid staff reductions.
Telehealth: A Partial Solution With Limitations
PPMI is expanding its virtual health services, which have become the organization’s most popular “clinic,” serving over 10,000 patients annually. Telehealth offers convenience, particularly for rural patients who can schedule appointments without travel or childcare hurdles.
However, rural areas like Michigan’s Upper Peninsula face significant obstacles:
- Limited cell and internet coverage.
- Long travel distances to alternative care.
- Some medical needs cannot be safely or effectively managed remotely.
Local health providers warn that telehealth cannot fully replace brick-and-mortar clinics, especially in underserved regions, where demand for gynecological and reproductive care already outstrips capacity.
Impact on Patients and Communities
Patients have voiced heartfelt thanks for the clinic’s care, with some describing it as life-saving. The closures risk creating “dark zones” where patients have little to no reliable access to affordable reproductive healthcare.
Community health workers, local departments, and private providers are scrambling to fill gaps, but many acknowledge the resulting patchwork system is inadequate to meet demand.
“We lost a very functional system,” said Viktoria Koskenoja, a former Planned Parenthood physician assistant. “Now, we’re just making it up as we go.”
Key Takeaways:
Clinic closures in abortion-legal states are driven primarily by financial, operational, and policy challenges, not legal bans.
Rising costs and funding cuts, particularly regarding Title X, threaten clinic sustainability.
Telehealth expansion helps but is not a full substitute for in-person services, especially in rural and underserved areas.
Community and health care workers face an urgent need to develop new strategies to maintain access and support for vulnerable populations.
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