UPDATE, March 20, 10:54 a.m.: Florida Gov. Rick Scott (R) on Monday signed the GOP bill to permanently fund fake clinics run by anti-choice activists, the Associated Press reports.

Florida GOP lawmakers sent a bill last week to Republican Gov. Rick Scott that would require the state to permanently contract with an organization funneling taxpayer dollars to so-called crisis pregnancy centers, fake clinics that use anti-choice propaganda to dissuade people from seeking abortion care.

But Florida is far from the only state to fund fake clinics. Anti-choice clinics will receive an unprecedented $40.5 million in taxpayer dollars from 14 states this fiscal year—even as lawmakers in these states slash funding for public health initiatives and increase requirements for people with low incomes to access public assistance programs.

An analysis by Rewire of state budgets, agency contracts, and other public documents found little transparency and limited oversight of the essentially unregulated organizations receiving millions in funding from Florida, Georgia, Indiana, Kansas, Louisiana, Michigan, Minnesota, Missouri, North Carolina, North Dakota, Ohio, Pennsylvania, Texas, and Wisconsin.

“It’s an abuse of public funds to provide even a penny to anti-abortion fake clinics that systematically deceive and shame people seeking abortion care,” said Erin Matson, co-founder and co-director of ReproAction, a pro-choice organization.

Fake clinics have come under increased scrutiny in recent years, as investigations revealed they disseminate misinformation to people seeking abortion care and neglect to follow proper medical protocols.

Matson questioned why these types of organizations need millions of dollars, especially considering most are staffed by volunteers and provide little if any medical care. “If these operations care about babies and poverty and prenatal care, why aren’t they organizing for Medicaid expansion?” Matson asked.

Legislators in seven of the 14 states that fund fake clinics have not expanded Medicaid under the Affordable Care Act, according to the Kaiser Family Foundation.

Texas accounts for nearly half of the $40.5 million in state funding of fake clinics. Over the past decade, Texas Republicans have annually increased funding for the state’s “Alternatives to Abortion” (A2A) program.

In June 2017, Texas Gov. Greg Abbott (R) signed an appropriations bill that allocated $38.3 million over two years for the A2A program, after the state’s GOP-held legislature approved an amendment to more than double the program’s funding.

The A2A program is administered by the state’s health and human services commission, which contracts with an outside organization to distribute the funds. The Texas Pregnancy Care Network, an Austin-based nonprofit, was awarded a contract to distribute funds to the subcontractors the network selects and oversees.

A Rewire investigation found that state-funded fake clinics provide limited services to clients and measure success only by the number of clients served. Public health programs are typically evaluated on measures of health-care outcomes or cost savings incurred by the state.

The Texas program is similar to the one in Florida, where the Department of Health awarded a $3.95 million contract to the Florida Pregnancy Care Network for providing pregnancy support and wellness services through 61 subcontractors operating 105 facilities.

This type of scheme has been replicated by several states that directly fund fake clinics.

Georgia Republicans last year passed a budget that included $2 million in funding for the Positive Alternatives for Pregnancy and Parenting grant program; the Georgia Department of Public Health contracted with Life Resources of Georgia to distribute the funds to organizations that promote pregnancy and parenting services as alternatives to abortion care.

A study published last year found that most anti-choice clinics in Georgia offer few services beyond pregnancy testing and counseling, and a majority of these facilities promote false or misleading information to pregnant people.

Indiana, Michigan, and Pennsylvania have similar programs and have each awarded contracts to Real Alternatives, a nonprofit organization that distributes state funding to a combined 144 fake clinics.

An investigation by Pennsylvania’s auditor general last year found that Real Alternative has misused state grants by spending a cut of the money on its network of fake clinics and anti-choice activities outside the state.

Pennsylvania funded Real Alternatives by diverting federal tax dollars from the Temporary Assistance for Needy Families (TANF) program.

Nine of the 14 states pumping taxpayer money into fake clinics—Indiana, Louisiana, Michigan, Missouri, North Carolina, North Dakota, Ohio, Pennsylvania, and Texas—siphon off federal funds from the TANF program to fund programs that funnel money to fake clinics. This year more than $13.4 million in federal dollars earmarked for families with low incomes will be used to fund programs that direct money to fake clinics that often provide minimal services.

“In some cases, dollars are directly diverted from public funds allocated to feed hungry children, all so that a woman looking for an abortion clinic can be told lies about abortion in a setting that often purposefully deceives her into thinking she’s walking into an abortion clinic,” Matson said.

“We need audits and investigations on how public dollars to fund fake women’s health centers are being used.”