WASHINGTON — Congress has taken its first step toward disentangling federal funds from Planned Parenthood, the nation’s largest provider of abortion, as well as contraceptive family-planning services.

But removing Planned Parenthood’s biggest source of funding — Medicaid reimbursement — is tied up with the repeal of the Affordable Care Act, and Republicans have yet to coalesce around a repeal-and-replace strategy.

The House of Representatives Feb. 16 voted 229-188 to pass H.J. Res. 43, which would overturn a regulation enacted in December by the Obama administration that barred states from disqualifying abortion providers, such as Planned Parenthood, from the Title X family-planning program.

A number of states had attempted to disqualify Planned Parenthood, or abortion-providers generally, from receiving Title X funds in the wake of undercover videos that showed Planned Parenthood and other abortion providers were harvesting fetal tissue and organs for scientific research facilities.

“They’re trying to put it back the way it was before, where states could prioritize [what entities get funding],” Jennifer Popik, legislative director of the National Right to Life Committee, told the Register.

The legislation, Popik said, now heads to the Senate, which has a slight bipartisan pro-life majority. If it passes there, she expected it would head to President Donald Trump’s desk for signing into law.

Planned Parenthood receives approximately $553.7 million in federal funding — the vast majority coming from Medicaid reimbursement. In fact, Planned Parenthood’s most recent annual report shows a 4.8% increase in government funding, even as its medical services dropped by 10.7%, according to a data analysis by the Heritage Foundation’s Daily Signal.

Pro-life advocates have their eyes set on cutting off Planned Parenthood’s federal revenue stream. One measure, proposed by Rep. Diane Black, R-Tenn., would put a yearlong moratorium on all federal funds to Planned Parenthood until it certifies that it no longer performs abortions. The other measure, from Sen. Joni Ernst, R-Iowa, would ban Planned Parenthood from federal funding indefinitely. Both measures aim to redirect federal funding to other health care entities that do not provide abortion.

Congressional Republicans have pledged to attach a defunding measure to the bill to repeal the Affordable Care Act, which would go through a process called budget reconciliation. The measure will get an up or down vote, bypassing the threat of filibuster in the Senate, which requires 60 votes on other legislation to end debate, and proceed to a floor vote.

Rep. Christopher Smith, R-N.J., co-chairman of the House’s bipartisan Pro-Life Caucus, told the Register that a great deal of pro-life legislation has been held up by the Senate’s filibuster rules. He said most of the House’s pro-life legislation cannot get an up or down vote in the Senate. Unless the Senate reforms its process, he said, “the most effective path forward is to make [defunding legislation] part of the reconciliation bill.”

“It will have a major impact on their ability to kill [unborn] babies,” he said.

 

Impact on Planned Parenthood

Mallory Quigley, spokeswoman for the Susan B. Anthony List, which has been lobbying for the defunding of Planned Parenthood, told the Register that the bills intend to redirect federal funds from Planned Parenthood to federally qualified health centers and rural health clinics that do not provide abortion and could provide “real health care alternatives for women and children.”

Quigley pointed out that there are more than 20 federally qualified and rural health clinics for every Planned Parenthood facility.

“None of these measures would actually cut a penny from women’s health or family-planning health,” she said. 

Quigley said SBA List is encouraging lawmakers to hold firm, adding, “The president himself has said in a letter to pro-life leaders that this is a priority.”

An analysis of Planned Parenthood’s figures shows the abortion giant had 2.5 million clients, according to its own 2014-2015 annual report. The vast majority of the non-pregnancy services it provided were STI/STD testing and treatments (4.2 million), contraceptive services (2.9 million), followed by more than 682,000 cancer screenings, largely consisting of breast exams and pap smear tests.

A small percentage of its clients obtained family medicine (up to 1.3%).

However, when it comes to pregnancy-related services, Planned Parenthood’s own figures show potentially up to 13% of Planned Parenthood’s clients obtained abortion services in 2014-2015. However, no more than 0.7% of Planned Parenthood’s clients obtained prenatal services in the same period.

A Register breakdown of the ratio of Planned Parenthood’s 1.2 million pregnancy tests to its abortion and prenatal services showed its clinics performed one abortion procedure for every 3.7 pregnancy tests it recorded, but provided only one prenatal service for every 70.5 pregnancy tests.

Planned Parenthood’s figures are even lower for adoption: one referral for every 600 pregnancy tests.

 

Planned Parenthood by the Numbers

From 2014-2015

  • 4.2 million: tests for sexually transmitted diseases/infections
  • 2.9 million: contraceptive services
  • 1.2 million: pregnancy tests
  • 682,000: cancer screenings, largely consisting of breast exams and pap smear tests
  • 13: percentage of clients who obtained abortion services (1 abortion for every 3.7 pregnancy tests)
  • 1.3: percentage of clients who obtained family medical services
  • 0.7: percentage of clients who obtained prenatal services (1 service for every 70.5 pregnancy tests)
  • 1: adoption referrals for every 600 pregnancy tests

Source: Planned Parenthood’s 2014-2015 annual report

 

Replacing Planned Parenthood

The U.S. Catholic bishops’ conference supports the moves in Congress to withdraw funds from Planned Parenthood and abortion providers, according to Greg Schleppenbach, the executive director of the U.S. Conference of Catholic Bishops’ Secretariat of Pro-Life Activities.

Schleppenbach told the Register that it was important for the Church to support and expand the scope of pro-life health work. He noted that many pregnancy care centers were trying to expand to a medical model that could provide women with health services. “Helping to create them would be a tremendous contribution to building a culture of life.”

“I think it is absolutely an essential function of our Catholic and pro-life communities to make sure there are alternatives and comprehensive pro-life services that can directly compete with Planned Parenthood and other clinics that either directly provide or do refer for other services that are contrary to our Catholic faith,” he said.

Pro-life health centers have begun to expand their footprint on the U.S. health care market, as an alternative to Planned Parenthood and other facilities that do not provide abortion but dispense contraception and may refer for abortion. Such pro-life health care providers include Stanton Healthcare, Gianna Centers, Guiding Star Centers and Obria Medical Clinics.

Kathleen Eaton Bravo is the president of the Obria foundation and founder of the Obria Medical Clinics. She said that pregnancy-resource centers need consistent private donors to help them add the services and medical personnel required to become pro-life health centers. She added that laws need to be reworked to maximize their ability to serve poor and low-income women and families and receive Medicaid reimbursements. Planned Parenthood’s own numbers report 79% of their clients are within 150% of the poverty level.

Bravo pointed out that some states do not have the kind of health care safety nets like California, where Medi-Cal provides insurance coverage to people within 138% of the poverty line. Pregnancy centers in rural areas, she said, have told her that they’d like to move to a medical model, but they cannot do so on their own because the area is so poor. They do not have the private funding to make the transformation, and they don’t have public funds to reimburse them for services sought by poor and low-income women.

She added that in states dominated by the abortion lobby, such as California, pro-life health centers such as Obria clinics are locked out of Title X funding because the state requires that they provide contraception or refer for abortion, which Obria will not do.

Bravo suggested that Congress could make adjustments to Title X, preventing discrimination against providers who only provide “natural” forms of family planning based on abstinence and fertility awareness methods, and possibly look at the concept of federal “mini grants” (which came out of the Bush administration’s faith-based initiatives project) as a way to funding pro-life clinics in rural areas and bypass states that prioritize public funds for facilities that provide contraception or refer for abortion.

She said pro-life health clinics, such as Obria, can break the life cycle that sends people going back to Planned Parenthood, treat the explosive rise of STDs and deadly HPV, and get them “off the slippery slope of hookups.” Many young people do not like Planned Parenthood, she added, but do not know what their alternatives are.

“We have an amazing opportunity,” she said.

“The young woman of today wants to be taken care of.”

 

Dueling Demonstrations

Defunding Planned Parenthood, however, currently is linked to the Republicans’ ability to repeal and replace the Affordable Care Act. The GOP has no agreed-upon plan yet for accomplishing this, and consequently has pushed the timetable for repeal.

At the same time, Planned Parenthood is flexing its own lobbying muscle to turn the heat on Congress, which is in the midst of a 10-day vacation. Republicans have already reported feeling the heat regarding the Obamacare repeal from constituents at town halls, who are concerned over the GOP’s health care intentions.

SBA List’s Quigley said Planned Parenthood has hundreds of millions of dollars at stake and would fight ferociously to keep it, because it has “everything to lose.”

More than 10,000 pro-life advocates gathered at some 227 locations in 43 states and the District of Columbia on Feb. 11 to call for the defunding of Planned Parenthood. But Planned Parenthood also organized demonstrations by supporters on the same weekend, sometimes at the same locations as the pro-life protests — and in some cases Planned Parenthood supporters outnumbered the pro-life demonstrators.

Pro-life leaders stress that grassroots pro-lifers must continue to remind Congress that defunding Planned Parenthood is politically wiser than backing down.

Rep. Dan Lipinski, D-Ill., the Democratic co-chairman of the House Pro-Life Caucus, told the Register that unless pro-life advocates voice their views publicly with sufficient force, defunding Planned Parenthood will turn into a fierce “uphill battle.”

“If pro-life supporters do not turn out,” he warned, “if they stay on the sidelines because they think they won the election, they’re going to be disappointed.”

 

Peter Jesserer Smith is a Register staff reporter.