Over the course of the past month, Planned Parenthood has been fighting for its life. President Trump’s plan to repeal and replace Obamacare came with two obvious stipulations that would not just harm but paralyze Planned Parenthood’s ability to operate. The plan would have revoked federal funding from any family-planning organization that a) provided abortion services and b) received over $350 million in federal funding.
Trump even gave Planned Parenthood an ultimatum: Remove abortions from its list of services and keep the government money. Planned Parenthood refused, not just on principle but because agreeing implied Planned Parenthood uses federal money for abortions, which it does not. Federal money is never used for abortion-related costs and hasn’t been since 1973. Government money is used solely for providing preventive care. It was a risky move, but it paid off. Last Friday (March 24), Speaker of the House Paul Ryan and President Trump called off the proposed health care bill due to lack of support not only from Democrats but also Republicans.
Planned Parenthood will survive another day. So long as Obamacare is still the law of the land, Planned Parenthood will continue to receive federal funding for the preventive care it provides. But is this a lasting victory for the organization or more of a brief moment of relief? Is it only a matter of time before its funding is threatened again? 43 percent of PP’s funding comes from the government and 60 percent of its patients rely on Medicaid to offset care costs. Here we take a closer look at exactly where Planned Parenthood’s money comes from and what the future of the women’s health clinic looks like now.
THE $ BREAKDOWN
Planned Parenthood wants this to be crystal clear: It does not receive a blank check from the government. Instead, the money from the federal government comes back to its bank account via reimbursements through two main programs: Medicaid and Title X. Let’s quickly talk about each.
Medicaid: A jointly funded, federal and state health insurance program for low-income people in 32 states and the District of Columbia. The future of Medicaid is currently up in the air as Trump’s new healthcare plan puts extreme restrictions on the federal government’s future involvement in helping fund the program.
Title X: A federal grant program that provides contraceptive education and counseling, pregnancy diagnosis and counseling, cervical and breast cancer screenings, and referral services associated with sexually transmitted diseases.
Here’s how the reimbursement process typically goes down: A patient comes in for medical care (like a pap smear, an STD test, a birth control prescription, etc.). She receives the care she needs. PP then submits a claim to its state’s Medicaid agency. That agency reimburses P and then sends the federal government a bill. The feds then reimburse their portion of the cost back to the state.
LET’S TALK NUMBERS
PP’s 2015 annual report notes that $553 million of their annual revenue came from Medicaid and Title X reimbursements. $663 million came from non-government services and private donations. So government money is not in the majority, but half a billion dollars would be a lot to suddenly lose should that day come.
When Trump’s administration proposed their healthcare plan, this probably seemed like a solid place to install cutbacks. But don’t take that number at face value. Planned Parenthood health centers prevent at least 579,000 unintended pregnancies a year. Pull the organization’s funding and watch pregnancies skyrocket by several thousand per year. And who pays for 45 percent of all births? Medicaid.
A letter by the Congressional Budget Office assessing what might happen if Planned Parenthood’s funding is cut notes that because of the increase in pregnancies, Medicaid spending would directly increase by $20 million in the first year. In the second year, it would go up by $130 million. In the third year, $650 million. Ultimately, the CBO estimates this would actually end up costing the government $130 million more than it’s paying now by 2025.
WHAT WOULD HAPPEN TO THE PATIENTS?
What’s the big deal, really? If Planned Parenthood’s funding is cut, can’t patients find another clinic nearby for the same services? In a word, no. In 21 percent of the counties where Planned Parenthood centers exist, there are no other clinics that provide the same services. 2.6 million clients rely on the clinic and nearly a quarter of those women (and men) would be left without nearby care.
Additionally, not only would overall Medicaid costs go up for the federal government, as noted before, but STD and cancer diagnoses would also spike. 45 percent of patients come to PP for STD testing and treatment and 21 percent come for cancer screenings.
WHAT DOES THE FUTURE OF PP LOOK LIKE?
Here’s the good news: As of today, Planned Parenthood’s patients are safe. They can continue to visit clinics across the country for the care they need. That will be the case so long as Obamacare remains the law. However, it’s unclear just how long that will be.
Trump’s healthcare plan failed the first time around, but his team could draft another version that might be able to get more Republican support. If that revised plan still includes clauses revoking federal funds from family planning organizations that provide abortion services and receive over $350 million from the government, that puts Planned Parenthood right back in the trenches.
And if Trump does get something like that approved, that means upwards of half a billion dollars would now need to be found elsewhere. Couldn’t PP then just ramp up its private donation effort? Yes, but that would be the equivalent of putting a band-aid on a gash. According to the CBO’s assessment, even if PP does manage to make up that loss initially, donations of this nature have proven to decline over the years. Providing more than two million Americans with healthcare isn’t sustainable through charity alone.
Additionally, the nomination of Supreme Court nominee Neil Gorsuch could potentially cause problems for Planned Parenthood. Multiple women’s organizations have expressed extreme concern over appointing Gorsuch as a Supreme Court judge. In the past, Gorsuch has ruled against women’s access to contraception and in favor of corporations (read more about that here). He has also sided with politicians who have tried to deny women and men access to basic health care (STD tests, reproductive health education services, etc.). These sort of actions might not result in a direct financial hit for Planned Parenthood, but it would certainly prevent the organization from doing its job to the best of its ability.
What do you hope to see in Planned Parenthood’s future? Share with us on Twitter @BritandCo.
(Photos via Getty)