It’s past time to end federal funding for Planned Parenthood. But how?
According to Planned Parenthood’s Annual Report, approximately 40% of the abortion providers funding comes from federal grants and reimbursements via taxpayers. The remaining 60% is sourced from private contributions and fees for services. This corresponds with the analysis by the Congressional Budget Office (CBO), as well.
The 40% of federal funding equates to more than $500 million annually. These federal monies come in two forms, Medicaid (90%) and Title X Grants (10%). Title X was signed into law in 1970 by President Richard Nixon to fund family planning and related preventative health services.
Medicaid is a fee for service program that pays medical providers a flat “fee” for services delivered. In general, it’s available to children, blind, disabled, elderly and pregnant mothers whose income is at or below 100% of the federal poverty level (FPL). Thirty-one states expanded Medicaid under the Affordable Care Act (ACA), which extended the program to able-bodied adults and also increased the financial threshold to $133% of the FPL. This is noteworthy because Planned Parenthood reports that 75% of their services are provided to those covered by Medicaid.
Title X is administered as a block grant to states, where it is allocated to organizations, such as Planned Parenthood, that provide family planning services. States have historically had some degree of discretion over disbursement of Title X funds. Arkansas, for example bars Title X federal funds from going to providers that also provide pregnancy termination services. In 2016, Florida enacted a law barring providers of abortions from receiving Title X funds, but federal judge Robert Hinkle blocked that law. Hinkle argued that abortion is a constitutional right and that therefore, barring funding of abortion providers is “unconstitutional.” Despite the uncertain outcome of these attempts, one still questions why states haven’t been more aggressive in declining to distribute Title X funds to abortion services providers, such as Planned Parenthood.
Now in accordance with the Hyde Amendment, federal monies cannot directly fund abortion services. However, Title X funds and even Medicaid reimbursements for non-abortion services allocated to abortion providers are fungible. Many of the costs to operate such clinics are shared – rent, power, insurance, common labor, federal payroll taxes, office and medical equipment. So it’s somewhat of a ruse to suggest that not a dollar of taxpayer money supports abortion. This money may not support abortions directly, but it certainly does support abortions indirectly.
In a typical business financial statement, that’s the hair-splitting exercise of categorizing direct costs (cost of goods sold) and general and administrative costs. This is the typical “above the line” versus “below the line” classification of business costs and expenses. But both are deducted from revenue to arrive at the most meaningful number: the bottom line. And revenue must cover both to produce a profit.
Two days prior to leaving office, President Obama signed an Executive Order preventing states from withholding funds from any family planning service provider, even if they perform abortions. This order was overturned by a law signed by President Trump on April 13 (Vice-President Pence was tie-breaking vote) allowing states to apply more discretion in allocating Title X funds, including denial of funding to abortion providers. Plus, to the chagrin of Democrats, President Trump recently appointed antiabortion activist Teresa Manning over the Title X program.
To fully strip federal funding to Planned Parenthood, Congress should act to amend Medicaid law to disallow participation in the program by clinics that terminate pregnancies or to share costs with other providers that perform abortions. It could be accomplished by an uncomplicated one-sentence bill. In the meantime, with a pro-life president, Title X funds should be all but fully prohibited from distribution to abortion providers.
It’s time for conservative lawmakers – at the state and federal level – to not just talk conservatively in order to be elected, but to govern conservatively.