(CNSNews.com) - The American Health Care Act—the Obamacare repeal-and-replace bill that the House of Representatives passed by a 217-to-213 vote this afternoon--will temporarily and significantly reduce, but not eliminate, federal funding for Planned Parenthood.
The bill will prevent Planned Parenthood from receiving funding through “mandatory” federal funding streams—primarily Medicaid—for exactly one calendar year after the president signs it.
But it does not prevent Planned Parenthood from getting “discretionary” funding through the Title X family planning program.
The “reconciliation” process that the Republican leadership is using to move this bill through Congress does not allow Senate Democrats to block it with a filibuster. As such, the Senate can pass it on a simple majority vote. However, while the reconciliation process allows changes to mandatory spending programs, it does not allow changes to discretionary programs.
In a 2015 analysis, the Congressional Budget Office summarized the amounts of federal dollars that Planned Parenthood gets annually from both mandatory programs (such as Medicaid and the Children’s Health Insurance Programs) and from the discretionary programs (such as Title X).
“Based on information from a variety of government and private sources, CBO estimates that Planned Parenthood receives approximately $450 million annually in federal funds,” the CBO said.
“Of that amount, roughly $390 million is provided through the Medicaid program and less than $1 million is provided through the Children’s Health Insurance Program and the Medicare program combined,” said CBO. “The remaining amount, approximately $60 million, is provided through the National Family Planning Program, which operates under Title X of the Public Health Service Act (commonly referred to as Title X). Funding for that latter program is subject to appropriation."
The Obamacare bill that the Republican-controlled House passed today does not mention Planned Parenthood by name, but instead describes what it calls a “Prohibited Entity.”
The bill stipulates that for “the 1-year period beginning on the date of enactment of this Act,” the “Prohibited Entity” and its affiliates, subsidiaries and successors may not receive money from Medicaid and certain other mandatory federal funding streams.
The “Prohibited Entity” described by the bill is a nonprofit that provides abortions and receives more than $350,000,00 per year from Medicaid.
In its analysis of the bill, CBO said these criteria apply only to Planned Parenthood.
“CBO expects that, according to those criteria, only Planned Parenthood Federation of America and its affiliates and clinics would be affected,” said CBO. “Most federal funds received by such entities come from payments for services provided to enrollees in states’ Medicaid programs.”
The report on this bill that was submitted to the full Congress by the House Budget Committee included “minority views” presented by the committee’s Democrats. These views cited the other mandatory spending flows that Planned Parenthood would be denied—for one year—under the bill.
“The Reconciliation recommendations deny mandatory funding to Planned Parenthood for one year, including reimbursements from Medicaid, as well as funding provided through the Children’s Health Insurance Program, Maternal and Child Health Services Block Grants, and Social Services Block Grants,” said the Democrats.
In March, after the CBO published its analysis of the bill, a House Republican aide confirmed that it did not stop Planned Parenthood from getting federal money through Title X.
“Prohibited entities can still receive money from the Title X National Family Planning Program--which is discretionary,” the aide told CNSNews.com.
In 2015, Sen. Joni Ernst (R.-Iowa) sponsored legislation—S. 1881--that would have completely denied federal funding to Planned Parenthood by cutting off both mandatory and discretionary spending.
That bill was only three pages long. Its key language simply stated: “Notwithstanding any other provision of law, no federal funds may be made available to Planned Parenthood Federation of America, or to any of its affiliates, subsidiaries, successors, or clinics.”
The Congressional Budget Office calculated that this 2015 bill would have stopped the flow of both the Medicaid and Title X money to Planned Parenthood.
“CBO expects that if S. 1881 was enacted,” the CBO wrote in a letter to Senate Budget Chairman Mike Enzi (R.-Wyo.), “most of the Medicaid services that would have been obtained from Planned Parenthood Federation of America would instead be obtained from other health clinics and medical practitioners—but not all of them.”
“As a result,” said CBO, “there would be some decline in the use of Medicaid services.”
CBO calculated that under S. 1881, the Title X money that was then going to going to Planned Parenthood would instead go to other groups.
“CBO estimates that the bill would not affect spending subject to appropriations, as any discretionary grants provided under Title X of the Public Health Service Act would probably be awarded to other health clinics or medical practitioners,” CBO said.
The Senate Republican leadership did not attach the language of S. 1881 to must-pass legislation such as a big continuing resolution, but instead brought it up as a stand-alone bill on Aug. 3, 2015. As such, Senate Democrats could kill it—and it alone--simply by denying it the 60 votes needed for cloture.
That same year, then-Rep. Mick Mulvaney (R.-S.C.)—who is now President Donald Trump’s budget director—led a group of 38 Republican House members who sent a letter to then-House Speaker John Boehner (R.-Ohio), saying they would not support any kind of federal funding bill that included any kind of funding for Planned Parenthood, including mandatory funding.
“Please know that we cannot and will not support any funding resolution--an appropriations bill, an omnibus package, a continuing resolution, or otherwise--that contains any funding for Planned Parenthood, including mandatory funding streams,” Mulvaney and the other 38 House members told Boehner.
The spending bill the Republican Congress is moving to enact this week to fund the federal government through the end of fiscal 2017 does not include any language restricting funding of Planned Parenthood in any way.
National Right to Life has conceded that the spending bill does not stop Title X money from going to Planned Parenthood.
“The spending bill provides continued funding for existing federal programs, including programs like Title X of the Public Health Service Act, in which Planned Parenthood affiliates are eligible to participate because there is no law that would exclude them,” National Right to Life says on its website. “In order to exclude Planned Parenthood, Congress would need to pass a new law.”
National Right to Life, however, said it supports the Obamacare reconciliation bill because, without having to muster the 60 votes to overcome a filibuster in the Senate, it would stop much of Planned Parenthood’s funding.
“National Right to Life fully supports the pending reconciliation bill H.R. 1628, the American Health Care Act, which not only strips Planned Parenthood of 89% of their funding, but makes dramatic prolife changes to the healthcare system and only requires 50 votes to pass,” the group says on its website.
Because this reconciliation bill would only deny Medicaid and other mandatory funding streams to Planned Parenthood for “the 1-year period beginning on the date of enactment of this Act,” Congress would need to pass another law within a year of when President Trump signs this one to maintain this restriction on Planned Parenthood’s funding.