What Defunding Planned Parenthood Could Mean for Women’s Health

Delivering a brutal yet familiar threat to Planned Parenthood on Thursday, House Speaker Paul Ryan declared that Congress would move to eliminate funding for Planned Parenthood. “The Planned Parenthood legislation would be in our [repeal] bill,” Ryan told reporters during his press conference.

His announcement came a day after a House panel convened by Republican majority leadership made the recommendation that Planned Parenthood be denied federal funding vis-à-vis Medicaid reimbursements and federal family planning programs.

Although Ryan had not yet offered specifics about what a defunding measure would look like, many assume it would take on the same structure as when Republicans in Congress last tried this move during budget proceedings in the fall of 2015, which almost resulted in a government shutdown. At that time, Republicans proposed that all federal funding for contraception and women’s preventive health care services be denied to any health care provider who also provides abortion care.

Cecile Richards, president of Planned Parenthood, was quick to respond with a statement. “Defunding Planned Parenthood is dangerous to people’s health, it’s unpopular, and it would leave people across the country without care,” she said. “Two and a half million women, men, and young people come through our doors every year for lifesaving care like cancer screenings, birth control, and STI and STD tests, and they cannot afford to have basic reproductive health care attacked. Planned Parenthood has been here for 100 years, and we’re going to be here for 100 more. Women and men in this country won’t let politicians like Paul Ryan and Mike Pence take us back decades.”

Richards continued, “It’s likely no accident that this attack was launched the day after Vice President-elect Mike Pence, a longtime opponent of Planned Parenthood, held a closed-door meeting with Speaker Ryan and the Republican leadership. Now that their plan is clear, Planned Parenthood, the Planned Parenthood Action Fund, the one in five women who have come to Planned Parenthood, the entire public health establishment, and the millions of supporters across the country are ready to defend care with everything we’ve got.”

Melanie Israel, a research associate at the conservative public policy think tank the Heritage Foundation and an expert on the anti-abortion movement and public policy, found Ryan’s announcement “exciting” and “very encouraging,” she tells Yahoo Beauty.

“Of course, we don’t have the exact language to look at yet, but operating under the assumption that the language will be the same as last year’s bill and thus exclude Planned Parenthood from Medicaid reimbursement while increasing funding for other community health centers, that would be a one-two punch of funding for women’s health — and not for Planned Parenthood,” Israel says.

Israel explains that, in her opinion, there is no risk for current Medicaid patients losing access to health care services should Planned Parenthood be eliminated as a Medicaid provider.

“There’s where increased funding for other health centers comes in,” she says. “Federally qualified health centers (FQHCs) outnumber Planned Parenthood 20 to one. … The argument that Planned Parenthood is the only option for most women just doesn’t hold up. Other health centers outnumber them, and now they will get increased funding.”

But Planned Parenthood plays a critical role in providing access to basic preventive, well-woman, and family-planning services that many Americans would otherwise lack access to. A 2015 analysis done at the time of the last attempt at federal defunding found that in two-thirds of the 491 counties in which they are located, Planned Parenthood centers serve at least half of all women obtaining contraceptive care from safety-net health providers. It also showed that in one-fifth of the counties in which they are located, Planned Parenthood sites are the sole safety-net family planning center.

Which is why many Planned Parenthood proponents call the argument that there are plenty of alternative providers a hollow one — as increased funding to those centers does nothing to help those who live in an area where no such center exists.

Still, Israel emphasizes that defunding Planned Parenthood may only mean eliminating the organization as a Medicaid provider, but not as a provider of family planning services through Title X, the federally funded family-planning program. A recent study by the Guttmacher Institute found that Planned Parenthood disproportionately serves Title X patients relative to other forms of Title X-funded centers like FQHCs.

“We’re not talking about closing Planned Parenthood across the country,” Israel says, “but just ending Medicaid reimbursement for them for one year.”

But Staci Fox, CEO of Planned Parenthood Southeast, asks, “How can anyone ensure that there will be providers to see Medicaid patients when the reimbursement rates do not even cover the costs?” She tells Yahoo Beauty that denying reimbursement for Medicaid services from Planned Parenthood providers means “specifically eliminating Planned Parenthood as a provider choice for preventive health care for 2.5 million Americans — many of whom will have no other place to go for care because other providers either do not exist in their communities or cannot absorb the patient volume.”

In March 2016, when Florida lawmakers proposed eliminating Planned Parenthood as a Medicaid provider in their state, the list of FQHCs Republicans offered as evidence of providers ready to absorb those patients included dentists, elementary school health clinics, and podiatrists.

The effects of defunding Planned Parenthood have been studied on a limited scale in Texas, which eliminated Planned Parenthood as a Medicaid provider in 2013 and implemented a state program for low-income women’s health care, the Texas Women’s Health Program. And already, research on the fallout, including a study published in the New England Journal of Medicine, has shown that the use of contraception has decreased, while unintended pregnancies have increased in the state.

It’s why so many women’s health care experts and advocates are especially troubled by Ryan’s announcement — and about linking it so specifically to the planned Republican repeal of the Affordable Care Act (ACA).

Ilyse Hogue, president of NARAL Pro-Choice America, tells Yahoo Beauty that Ryan’s statement “is a textbook case of GOP overreach. When the vast majority of Americans voted for Democrats in the Senate and the White House, when even Trump voters have expressed surprise since the election to hear that cutting health care and defunding Planned Parenthood are under consideration, this speaker has no mandate.”

Ryan’s position “is the height of hypocrisy,” Hogue continues. “You can’t claim to be for saving Americans money and go after the $1.4 billion in savings for women due to birth control coverage. You can’t oppose abortion services and then take away the tools that have helped keep unintended pregnancy at an all time low. Last I checked, Planned Parenthood’s approval ratings were far higher than those of Speaker Ryan’s Congress, so he best proceed with care.”

Further, Israel points to the debunked “sting” videos produced by the anti-choice activist group the Center for Medical Progress as the key reason why such defunding is so necessary.

“The videos released in 2015 were absolutely disturbing,” she says. “And for a lot of people across the country, it makes them think, ‘Wait a minute — are these my values? Is this the kind of organization I should be sending limited taxpayer dollars to when there are other entities out there that I could be sending them to that are not entangled in this? … Those videos sent renewed excitement in the pro-life movement to speak out and confidently say, ‘Here is another reason why we need to make sure that taxpayer money doesn’t go toward abortion services.'”

Because of the Hyde Amendment, passed in 1976, no federal funding of any kind may be used for abortion care, making abortion the only medical procedure to be banned from Medicaid coverage. But, Israel insists, “Money is always flexible — and entangling tax dollars with abortion in any way is not acceptable.”

Still, notes Fox, through its myriad health services, “Planned Parenthood does more to prevent abortions than any single organization in this country.”

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