WASHINGTON ― House Speaker Paul Ryan (R-Wis.) has vowed to “defund” Planned Parenthood in upcoming legislation. But what he and Republicans in Congress are trying to do is actually very different from what that word suggests.
The government does not cut a blank check to Planned Parenthood. The family planning provider is listed nowhere in the federal budget, and a law already prevents taxpayer dollars from being used to pay for abortions. Planned Parenthood is only reimbursed for the non-abortion health care services it provides to low-income women, including birth control, Pap smears, breast exams and STI tests, through Medicaid and the Title X family planning program.
What the GOP’s plan would do is prevent Medicaid from working with Planned Parenthood. This would effectively block patients who rely on federally subsidized health care ― about 60 percent of Planned Parenthood’s 2.5 million patients ― from choosing Planned Parenthood for their health care. And by rendering the family planning provider unable to serve more than half its patients, the bill would likely force some of its clinics to shut down.
“It’s important to understand that Planned Parenthood works like every hospital, every other health care provider in this country. We get reimbursed for preventative health care, period, end of story,” Cecile Richards, president of Planned Parenthood, told The Huffington Post on Wednesday. “Speaker Ryan is threatening to say women in this country can no longer go to the health care provider of their choice. It’s simply un-American and completely irresponsible to say to folks, ‘Go try to find somewhere else on your own.’”
Republicans in Congress have been trying to “defund” Planned Parenthood for years, even threatening to shut down the federal government over the issue in 2011, because some of Planned Parenthood’s clinics offer abortions. A piece of legislation known as the Hyde Amendment has long prevented federal dollars from being used to pay for abortion. But conservatives often claim that the money Planned Parenthood receives annually in reimbursements through Medicaid and Title X for preventive health care ― about half a billion dollars ― is “fungible,” meaning that it frees up other money for abortions.
This, however, is not true. Women pay out of pocket for abortions at Planned Parenthood unless their health insurance plan covers the procedure. And in many cases, the federal money that Planned Parenthood receives for preventive health care only partially reimburses the clinic for the cost of the service, leaving the family planning provider with no excess money to use for other things.
The other myth Ryan has perpetuated is that there are enough federally qualified community health centers to absorb Planned Parenthood’s patients. “For every Planned Parenthood, there are 20 federal community health centers,” Ryan said at a town hall in January. “They’re vastly bigger in network, there are so many more of them, and they provide these kinds of services without all of the controversy surrounding this [abortion] issue.”
This is true ― if you include dentists’ offices, homeless shelters, food banks, mental health clinics and cosmetic surgeons in your count. But in reality, while community health centers do greatly outnumber Planned Parenthood clinics, many of them don’t offer women’s health and family planning services. In 2014, federally qualified health centers only provided about a third of the contraceptive services that Planned Parenthood did, according to the Congressional Research Service. And the average wait time for an appointment at these health centers is more than twice the wait time at Planned Parenthood ― which could be deadly for a woman like Jaime Benner, who found a lump in her breast in 2013.
Benner, a then-unemployed and uninsured mother of two in rural upstate New York, says that when she called her local Planned Parenthood clinic to tell them she felt a lump, they shuffled around their appointments and got her in the same day. After conducting a breast exam and referring her to a radiologist, a staffer at Planned Parenthood actually applied to Medicaid on Benner’s behalf so she could focus on her health without worrying about money. Benner learned that her aggressive breast cancer was already spreading to her lymphatic system, and she was able to have an emergency double mastectomy that saved her life.
“Without Planned Parenthood I would be dead,” said Benner, 31. “Literally, where I live, everything is a three-week to two-month waitlist. I wouldn’t have been able to get in anywhere in time, and no one would have helped me get Medicaid. I would be dead.”
Republicans know, on some level, that Planned Parenthood is a risky target. At a closed-door meeting in January, some GOP lawmakers fretted that attacking Planned Parenthood while repealing the Affordable Care Act would be politically detrimental for them. “We are just walking into a gigantic political trap if we go down this path of sticking Planned Parenthood in the health insurance bill,” Rep. John Faso (R-N.Y.) reportedly said, to tepid applause.
Democrats, meanwhile, have the numbers in the Senate to block any bill that “defunds” Planned Parenthood, and they’ve vowed to do so.
“The people that attack women’s health, they are so dumb politically,” Senate Minority Leader Chuck Schumer (D-N.Y.) said at a Planned Parenthood rally in Washington, D.C., on Wednesday. “They don’t get it. They let ideology and condescension to women and sometimes just meanness overcome everything else, and they lose. And they’re going to lose again.”
CORRECTION: This article initially understated how much money Planned Parenthood receives in reimbursements from the federal government.