For years now Republicans in Congress have expressed their intention to repeal Obamacare and defund Planned Parenthood. Although they failed to accomplish either goal individually, they came up with the bright idea of introducing a bill that would jointly achieve their objectives.
If it passes.
Because the Republicans had nearly absolute control of the government once Donald Trump was sworn into office, they could have had a bill to repeal Obamacare waiting on his desk in the oval office for his signature on Inauguration Day. A simple one-sentence bill is all that was necessary: “The Patient Protection and Affordable Care Act (PL 111-148, 124 Stat. 119 through 124 Stat. 1025) is hereby repealed.”
But because the Republicans were fixated on the need to “repeal and replace” Obamacare instead of just getting rid of Obama’s collection of tax increases masquerading as a health-care bill, back in March they introduced a replacement for Obamacare called the American Health Care Act of 2017 (AHCA). Their bill to establish Republicare was withdrawn after the House Republican leadership realized that they did not have enough Republican votes to pass it.
Then, after some tweaking, the House, by a vote of 217 to 213 (20 Republicans and all Democrats voted no), passed the AHCA bill (H.R.1628) on May 4. But instead of acting on the House bill, the Senate came up with its own bill in the nature of a substitute called the Better Care Reconciliation Act of 2017 (BCRA). It has yet to be voted on. Although there are some differences between the two bills, both have identical language ending federal Medicaid reimbursements to Planned Parenthood for one year.
Founded in 1916, Planned Parenthood Federation of America, according to its website,
- delivers vital reproductive health care, sex education, and information to millions of women, men, and young people
- is America’s most trusted provider of reproductive health care
- is a respected leader in educating Americans about reproductive and sexual health
- advocates for sound U.S. foreign policies that improve the sexual and reproductive health and well-being of individuals and families globally.
Its mission is
- to provide comprehensive reproductive and complementary health care services in settings which preserve and protect the essential privacy and rights of each individual
- to advocate public policies which guarantee these rights and ensure access to such services
- to provide educational programs which enhance understanding of individual and societal implications of human sexuality
- to promote research and the advancement of technology in reproductive health care and encourage understanding of their inherent bioethical, behavioral, and social implications.
Planned Parenthood has 56 independent local affiliates that operate more than 600 centers across the country. According to Planned Parenthood’s most recent annual report, 41 percent ($555 million) of the organization’s revenue comes from government reimbursements and grants.
Planned Parenthood is also the nation’s largest abortion provider, performing more than 320,000 abortions a year — more than 30 percent of the nation’s annual total.
Congressional Republicans want to defund Planned Parenthood because it performs abortions. That, of course, means that the organization has been previously funded. And funded it has been — for years, by Republicans, most recently in the omnibus spending bill (H.R.244) to fund the government for the rest of the fiscal year that was signed into law by Trump on May 5. If Republicans, the vast majority of whom would say they are against abortion, are so opposed to Planned Parenthood because it performs abortions, then why did they fund the organization with millions of taxpayer dollars during the Bush years when they had a majority in both Houses of Congress for more than four years?
Just to clarify, the federal government does not directly fund abortions, except when it does. Congress passed the Hyde Amendment in 1976 — three years after the historic Roe v. Wade Supreme Court decision that effectively overturned most state abortion laws. It prohibits federal Medicaid coverage of abortions, except when the pregnancy will endanger the woman’s life or results from rape or incest. However, it doesn’t prevent the states from using their own funds to pay for abortions, and seventeen states do provide abortions to women enrolled in Medicaid. Conservatives argue that because the federal dollars given to abortion providers such as Planned Parenthood are fungible, no abortion provider should be eligible for Medicaid reimbursements, not even for cancer screenings, birth control, or preventive care.
Both the AHCA and the BCRA would cut off federal Medicaid payments to Planned Parenthood for one year (about half of Planned Parenthood patients are on Medicaid) and prohibit most consumers from using tax credits to help buy insurance that includes coverage for abortions.
The bills don’t actually mention Planned Parenthood. What they do say is that
for the 1-year period beginning on the date of the enactment of this Act, no Federal funds provided from a program referred to in this subsection that is considered direct spending for any year may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State.
The bills define a “prohibited entity” as “an entity, including its affiliates, subsidiaries, successors, and clinics”
(A) that, as of the date of enactment of this Act —
(i) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code;
(ii) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations (as in effect on the date of enactment of this Act), that is primarily engaged in family planning services, reproductive health, and related medical care; and
(iii) provides for abortions, other than an abortion —
(I) if the pregnancy is the result of an act of rape or incest; or
(II) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and
(B) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000.
The bills don’t block the millions in Title X family-planning funds Planned Parenthood receives annually.
Naturally, the president of Planned Parenthood opposes the bills and has promised intense lobbying to try to defeat or alter them. Cecile Richards said in a statement, “Slashing Medicaid and blocking millions of women from getting preventive care at Planned Parenthood is beyond heartless. One in five women in this country rely on Planned Parenthood for care. They will not stay silent as politicians vote to take away their care and their rights.” She also termed the proposed legislation “the worst bill for women’s health in a generation.”
Planned Parenthood should certainly be defunded, but not because it performs abortions or does anything else that conservatives don’t like.
There are three simple reasons why Planned Parenthood should be defunded.
First of all, the Constitution nowhere authorizes the federal government to fund private organizations or businesses that provide services. Here is something that Democrats and Republicans, liberals and conservatives, pro-choicers and pro-lifers should all be in perfect agreement on.
Second, it is an illegitimate function of government to take money from individuals and businesses through taxation and transfer that money to organizations or businesses that provide services — even to nonprofits, even to organizations that don’t perform abortions, and even to businesses that provide important services. Businesses should charge for all services they provide and organizations that provide free or low-cost services should be funded by private grants and individual donations. If businesses can’t get enough customers and organizations can’t get enough grants or donations, then they should close.
Third, if it is okay for a private organization or business to receive government funds for providing family planning, STD testing, or cancer-screening services, then no logical argument can be made against a private organization or business to receive government funds for providing pest-control, auto-repair, hairstyling, house painting, or landscaping services.
It is not just Planned Parenthood that needs to be defunded. All organizations and businesses on the federal dole should be defunded.