It’s about more than just abortions
(Reproductive Health Supplies Coalition / Instagram)
The fight for who controls women’s bodies is once again indirectly on the ballot this November.
He praised himself and all the things he’s done to earn the title “the most pro-life president in our nation’s history,” and touched on his plans to continue in this endeavor if reelected, namely defunding Planned Parenthood.
But “defunding” isn’t as simple as it sounds; there’s no allowance that Trump takes away to shut its doors.
How is Planned Parenthood funded?
Only 34% of Planned Parenthood’s revenue comes from government funding.
Between $50 and $60 million of the $564 million Planned Parenthood received from government reimbursements and grants in 2017 came from Title X grants, a federal family planning program.
Trump’s Department of Health and Human Services implemented a gag rule in July 2019, prohibiting Title X funded health care providers from referring patients for abortion care. This means all clinics that receive Title X funding must direct all pregnant patients to prenatal care services, regardless of their choice.
Title X funds have never been used to pay for abortions thanks to the Hyde Amendment, a measure that prohibits the use of federal funds for abortions.
In August 2019, Planned Parenthood direct grantees and subgrantees withdrew from the Title X program.
The majority of government funding comes in the form of Medicaid reimbursements.
Medicaid, a government-funded insurance plan for people with low incomes, works just as any other insurance plan would. You go to the doctor and receive care, then pay your copay and your insurance (if you’re lucky enough to have some) covers to rest.
So, the majority of government “funding” for Planned Parenthood is from insurance reimbursements for preventative care.
So how does Trump plan to “defund” Planned Parenthood?
If Trump were to “fully defund” the organization, as he claims he will, that could mean blocking those with Medicaid from using it at Planned Parenthood and similar clinics. As of right now federal law states that Medicaid users can choose whichever provider they want in a family planning context.
Trump can’t do anything about this on his own. Republicans would need to win back the majority to “overcome Democratic filibusters in Congress” (another one of Trump’s goals) to have a chance of changing these laws.
The administration could also take another route — one that they’ve gone down before. In 2018, the Centers for Medicare and Medicaid Services (CMS) undid an Obama-era guidance that denied states from independently trying to block Planned Parenthood from receiving Medicaid funding.
If the law is overturned, that means millions of people who depend on Medicaid and other public health care programs will be blocked from getting care at Planned Parenthood.
Let me paint you a picture of a world without Planned Parenthood:
Let’s say Trump is reelected. He gets his Republican Congress. They rewrite the law, barring the use of Medicaid at Planned Parenthood.
Planned Parenthood doesn't immediately go down, it still has other means of funding. But it keeps getting knocked around by Trump, by Congress, maybe even by the Supreme Court.
It's under immense pressure now. It’s understaffed, overworked and underfunded.
It can no longer accommodate patients with same-day appointments and by staying open late when the county health center doesn’t have an available appointment for three months, and they have urgent health concerns.
The more than 600 Planned Parenthood clinics nationwide all shut down, 54% of which were in rural or underserved areas.
390,000 women lose access to services, while another 650,000 will have reduced access within the year. Some women will go to other community health centers, but others will die unnecessarily simply because they won’t be able to access basic health care.
When Planned Parenthood clinics closed in Wisconsin and Texas, women we’re faced with having to travel an extra 100 miles to reach the nearest health center. This led to a 6% decrease in breast exams, and a 9% decrease in access to Pap tests.
Some people will have nowhere else to turn for reproductive care, as Planned Parenthood is the only safety-net family planning provider in 21% of counties it's in.
People will lose a safe haven while seeking medical care. They’ll have nowhere to turn when their doctor refuses to prescribe birth control pills because he believed it was “improper for an unmarried woman to have contraception.”
There would likely also be an increase in STDs, maternal mortality and infant mortality. Pregnancy-related deaths nearly doubled in the years following the 2011 reduction of funding for Planned Parenthood in Texas.
There could be at least 579,000 unintended pregnancies in the year following Planned Parenthoods closure. About 64% of the 19 million women who require publicly supported contraceptive services live in counties with a Planned Parenthood (30% of those women live in counties where PP serves the majority of those receiving this contraceptive).
More unwanted pregnancies inevitably leads to the thing the government was trying to stop in the first place: abortions. In the years following Texas’ reduction of Planned Parenthood funding, teen abortion rates rose by an average of more than 3% over three years.
A rising abortion rate in a state where Planned Parenthood is no longer contributing, among a nation with decreasing abortion rates across the board, makes it almost seem like defunding may not be the best course of action.
“Defunding” Planned Parenthood is not harming a corporation, or a practice or even an ideal; it’s harming thousands of people who rely on it for basic and reproductive healthcare. People who, without it, will be unable to access the most basic or urgent of care.