Last week, House Speaker Paul Ryan assured reporters that the forthcoming bill to repeal the Affordable Care Act would include a provision denying federal funds to Planned Parenthood. This is supposedly pro-life, but it’s a major threat to the lives and well-being of thousands of low-income women.
Republicans (and some Democrats) have put Planned Parenthood in the bull’s eye because it’s one of the country’s largest providers of abortion services — and in some areas, the only provider.
Yet abortions represent a small fraction of the services Planned Parenthood provides—about 3% in 2014-15.
And those abortions are rarely, if ever, funded by the federal sources Republicans would shut off — Medicaid and Title X of the Public Health Services Act. An amendment routinely attached to spending bills has seen to that.
So the loss of federal funds would deny both women and men other health services — notably, tests and treatment for sexually transmitted diseases, pap smears, breast exams and affordable, reliable contraception.
Shrinking Planned Parenthood’s resources would thus increase health risks — and the risks of unwanted pregnancies. The latter, among other things, would keep more women mired in poverty and increase the number of children born and likely to remain poor.
Defunding Planned Parenthood is hardly a novel notion. So we have some evidence of consequences. Texas shifted its family planning funds out of Planned Parenthood in 2013—this after cutting its family planning budget.
Researchers found a 35% drop in the number of women using long-acting, reversible contraceptives supplied by clinics the state funded. The pregnancy rate among women who’d previously used injectable contraceptives—an alternative long-acting form of birth control—rose 27%.
Another study looked at what happened in Texas and Wisconsin when clinics closed because they’d lost public funding. Researchers found that fewer women got Pap smears and breast exams — in both cases because they’d have had to drive much further to get to a clinic.
About 40% of Planned Parenthood’s funds come from Medicaid, through reimbursements, and Title X, through grants. These sources cover care for approximately 60% of its patients—roughly 1.5 million people.
Republicans have said that the funds they’ll deny Planned Parenthood will go to other organizations and thus sustain the services its clinics can no longer provide.
This might be true in the long-run. But it surely wouldn’t before many thousands of women suffered irreparable harms. Professor Sara Rosenbaum, who’s worked with community health services for years, cites three major reasons.
Rosenbaum was responding to a defunding bill introduced in the Senate about a year and a half ago. The House actually passed a one-year defunding bill shortly thereafter.
The Congressional Budget Office assessed that bill and concluded that it would have caused an estimated 400,000 Planned Parent clients to lose access to care while also increasing federal Medicaid costs due to more unintended births.
The fate of these vulnerable people—and thousands who’ll come after—hinges on the Republican leadership’s getting a simple majority of votes in favor of the vehicle chosen to repeal the ACA. Some have suggested they might not get there. A very iffy prediction.
Our incoming President has talked on both sides of his mouth on this, as on other issues. But he’s said he’ll sign a defunding bill so long as Planned Parenthood is involved in abortions.
What this means, of course, is that we’re looking at even worse prospects for comprehensive, affordable health care than what we glean from the ACA dismantling in the works.
NOTE: I’m indebted to posts by Judith Solomon at the Center on Budget and Policy Priorities for data and links to original sources on the impacts of the prospective defunding. You can find her latest here.