When the Senate’s late July attempt to repeal the Affordable Care Act (ACA) failed in a dramatic late-night vote, many breathed a sigh of relief. The repeal would have spelled disaster for many, including low-income individuals, those with disabilities, women of color — and Planned Parenthood. Both the House and Senate versions of health care would have defunded Planned Parenthood, so it seems that the reproductive health clinic is safe. For now, anyways — this isn’t the first time Republicans have tried to defund the clinic, and it won’t be the last. So: what happens if Planned Parenthood is defunded?
Planned Parenthood receives approximately $528 billion in federal funds each year, so without that money, the clinic would face a major crisis. But while conservative politicians often talk about defunding Planned Parenthood, and regularly introduce legislation to do so, defunding Planned Parenthood isn’t just a matter of taking away dollars. There isn’t a line-item in the federal budget that Trump or either chamber of Republican-controlled Congress could just eliminate.
Planned Parenthood doesn’t receive a check from the federal government.
At least — not in the way you think. Planned Parenthood doesn’t just receive a check which it can dispense at-will to varying programs and clinic affiliates.
Planned Parenthood’s federal funding comes, instead, in the form of reimbursements for public insurance programs, including Medicaid, which completely covers low-income individuals, and Title X, which provides comprehensive family planning care to low-income individuals.
According to the clinic’s 2015-2016 Annual Report, in 2015, 2.4 million people used services at one of their approximately 650 health centers around the country. 11 percent of those 2.4 million were men. At least 1.5 million of these patients rely on Medicaid and Title X to receive care. And according to a Government Accountability Office report in 2015, almost 80 percent of patients had incomes at or below 150 percent of the federal poverty level.
These reimbursements allow Planned Parenthood to serve low-income individuals and families. Without them, the clinic wouldn’t be able to accept public insurance plans, nor would it be able to subsidize low-cost care for those without insurance.
So how would the defunding process work?
Because the clinic’s federal funding comes from Medicaid and Title X reimbursements, the government would have to strip half a billion dollars in funding for low-income Americans. More than half of the clinic’s patients rely on Medicaid, according to Planned Parenthood Action Fund. At least 60 percent of patients rely on some form of public insurance.
In the Senate’s version of the ACA repeal, the Better Care Reconciliation Act — which did not pass — Planned Parenthood would have been stripped of all Medicaid reimbursements for a year, and its reimbursement budget would have been reduced over the course of 10 years, to the point that it functionally wouldn’t have been able to serve Medicaid patients. Similarly, a January 2017 bill, introduced to the House of Representatives, would have stripped all federal funding to the clinic and all affiliates for a year.
Without reimbursements, Planned Parenthood couldn’t accept government-funded insurance plans. Individuals on government-funded insurance plans like Medicaid and Title X would not be able to use services at Planned Parenthood.
Who would defunding Planned Parenthood affect?
Defunding Planned Parenthood would have a disproportionately negative impact on some of the most vulnerable populations in the U.S.; as we mentioned above, at least 1.5 million of their patients rely on public insurance. The Guttmacher Institute considers public programs “central to women’s access to affordable contraceptive services and supplies and their ability to use contraceptives effectively.” Without Planned Parenthood, a shameful number of women (and men) would be cut off from those important services.
Further, Planned Parenthood is the only reproductive health clinic in 105 counties in the U.S., according to the National Campaign to Prevent Teen and Unplanned Pregnancy, to say nothing of the counties with zero publicly-funded reproductive health clinics.
The clinic states in its annual report that only 3 percent of its services are related to abortion. This would mean cutting off birth control services, preventive care, and STI screenings for vulnerable populations — which would likely lead to thousands of births. Unplanned pregnancies cost taxpayers upwards of $21 billion per year, according to The Washington Post, to say nothing of the cost of treating medical conditions that could be caught by screenings and pap smears.
We have an idea of what defunding would look like.
We already know what a disaster defunding the clinic would be, thanks to Texas.
In 2011, the Texas legislature slashed the two-year budget for funding family planning from $111 million to $38 million — in an effort to defund Planned Parenthood, The Washington Post reports.
Low-income women said it was harder for them to obtain birth control. Access to IUDs and other effective contraceptives became limited.
Clinics that provided abortion services — including Planned Parenthood — were excluded from the state’s family planning Medicaid reimbursement plan. Planned Parenthood had, until this legislation, cared for more than 40 percent of the program’s clients.
82 family planning clinics closed or stopped providing family planning services. That’s one out of every four in the entire state. Most of the clinics that closed weren’t in any way associated with Planned Parenthood.
Texas has one of the worst maternal mortality rates in the developed world, according to the Texas Observer. And experts expect similar outcomes if Planned Parenthood is successfully defunded.
Why do some politicians want to defund the clinic?
Planned Parenthood is a vocal advocate for women’s reproductive rights. Through advocacy, the clinic has become a symbol for open access to reproductive rights in the U.S. — including abortion.
Though the clinic cannot use federal funds for abortion thanks to 1977’s Hyde Amendment, many conservatives still believe that Planned Parenthood, by receiving federal funds, is able to perform abortion services. And in 2015, a deceptively edited video by the Center for Medical Progress claimed to have proof that the clinic sells aborted fetal parts for money — a claim which was swiftly determined to be untrue.
So, despite the fact that the clinic serves millions of low-income Americans and is the only place where many women and men can receive preventive care like pap smears, STI testing, and cancer screenings, the fact that some of their clinics provide abortion services is a sticking point.
All that said, Planned Parenthood is still here and still providing crucial services for women and men. And that doesn’t seem likely to change anytime soon.
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