Last week I noted that Planned Parenthood does not make 80% of its revenue from abortions. Based on a rough estimate, the actual percentage of its revenue that comes from abortions is 15% tops. But in the midst of talk about defunding Planned Parenthood by cutting off its access to government funds—which make up 41% of its revenue, and do not pay for any abortions—I think it’s important to ask what is meant by “government funding.”
Those public funds come from two programs: Medicaid, the health care program targeted at lower-income Americans, and Title X, a federal family planning program that likewise primarily serves lower-income Americans. The overwhelming majority of federal funding to Planned Parenthood comes from Medicaid — 75 percent, according to a Planned Parenthood spokesman.
According to abortion opponents, government funding makes up 41% of Planned Parenthood’s annual revenue. While technically true, this is severely misleading when stated as such, because by far the majority of that money is the same kind of money your doctor receives when providing services for patients who qualify for medicaid. It’s not that the government is doing Planned Parenthood some sort of special favors here—they’re not. Any medical clinic or hospital that provides services for patients who qualify for medicaid will be reimbursed through medicaid rather than through a for-profit health insurance company.
Medicaid funding is actually provided by state governments rather than directly by the federal government. In recent years, several states have attempted to bar Planned Parenthood from receiving Medicaid funds. However, federal law requires states to allow Medicaid beneficiaries to receive service from any qualified provider. This makes sense. After all, we’re talking about patients’ ability to chose their own doctor or care provider—something Republicans have said over and over gain that they’re in favor of. If state governments restrict who can receive reimbursements for providing care to Medicaid beneficiaries, they restrict Medicaid beneficiaries ability to access care and to chose their own care providers.
Nevertheless, abortion opponents want to strip Planned Parenthood of Medicaid funding. Last week the House passed a bill that would allow states to bar Planned Parenthood from receiving Medicaid reimbursements. This would have the practical effect of limiting Medicaid beneficiaries’ ability to access care and chose their own providers. For many low income women, Planned Parenthood clinics are the most accessible way to obtain birth control. Planned Parenthood clinics are often located conveniently for these women, and it is frequently easier to make an appointment at a Planned Parenthood clinic than it is to make an appointment at a doctor’s office. Indeed, six in ten women who receive care at a clinic like Planned Parenthood consider that clinic their primary provider of medical care. If states arbitrarily bar Planned Parenthood from receiving Medicaid reimbursements (and it would be arbitrarily), these women will be forced to find other means of accessing birth control.
According to US News & World Report:
Defunding Planned Parenthood or otherwise limiting patients’ access to its services nationally would harm women and families across the country who rely on the organization for care. And claims that other health care providers would step in to provide services in the absence of Planned Parenthood are simply unrealistic: In more than one-fifth of counties with a Planned Parenthood clinic, they are the sole provider of publicly funded family planning services.
For those with urgent medical problems, irregular work schedules or without paid sick leave, the flexibility and quick access to care offered by Planned Parenthood is critical. Planned Parenthood health centers provide service more quickly than other health centers that receive federal funding. For example, 63 percent of Planned Parenthood clinics offer same-day services, compared to 30 to 40 percent of other federally and state-funded organizations. It takes on average five to six days to get an appointment at most federally and state-funded clinics; at Planned Parenthood, it’s just 1.8 days.
I remember the debates that swirled when Obamacare was passed. The Republicans spoke almost nonstop about the importance of leaving people’s healthcare decisions in their own hands—about keeping the government from making our medical decisions for us. And now the Republicans want to control where low-income women can receive care by, in effect, barring them from receiving care at Planned Parenthood. Remember, we’re not talking about abortion here. We’re talking about birth control and STD testing, among other basic healthcare services. For many low-income women, Planned Parenthood is the most accessible place to receive this care. Too bad, abortion opponents would tell these women. Too bad.
This is arbitrary, and hypocritical, and ridiculous—and that’s putting it nicely.
Any attempt to bar Planned Parenthood—a qualified provider—from receiving Medicaid reimbursements for providing birth control, STD testing, and other women’s healthcare services to Medicaid beneficiaries is not about reducing abortion. In fact, the Congressional Budget Office has estimated that defunding Planned Parenthood would result in an increase in unplanned pregnancies, and that in turn would lead to an increase in abortions. Defunding Planned Parenthood is about punishing Planned Parenthood for providing abortions by making it more difficult to provide women with birth control and other women’s healthcare services.
The Right would have you think that Planned Parenthood were in the business of making money off of abortion. They’re not. First of all, if they were, promoting and providing birth control would be counterproductive. But second, while abortion may be one of the most expensive procedures Planned Parenthood provides women, but it is also one of the most expensive procedures to offer. Planned Parenthood is not profiting off of abortion. Far from it. Planned Parenthood’s goal is to empower women to make their own reproductive decisions, which starts with sex education and birth control. In fact, many if not most Planned Parenthood clinics do not even offer abortions (true story: I have spent the vast majority of my life living places where Planned Parenthood has a clinic but does not provide abortion services). Defunding Planned Parenthood would not cut the abortion rate. Instead, it would cut the amount of birth control and other women’s health services Planned Parenthood can offer by barring low-income women from receiving services at its clinics.
I cannot emphasize enough how upset I am by the way Medicaid reimbursements are being discussed in this debate. Medicaid is not the government handing a clinic money for nothing. Medicaid is the government giving a low-income individual the ability to receive healthcare services from the clinic or doctor of their choosing. Medicaid beneficiaries have a difficult time accessing care already, because Medicaid reimbursements for services are so low that some doctors do not accept patients who are on Medicaid. No one is getting rich off of providing services for Medicaid beneficiaries, and further limiting Medicaid beneficiaries options for receiving care is absolutely beastly.
Now let’s talk about Title X funding. According to the Congressional Budget Office:
In 2013, Planned Parenthood received approximately $60 million under Title X. Services funded by Title X include contraceptive education and counseling; pregnancy diagnosis and counseling; cervical and breast cancer screening; and education, testing, and referral services associated with sexually transmitted diseases.
In other words, only 5% of Planned Parenthood’s entire budget ($1,145.8 million) comes from Title X funding, and that funding goes for—well, you can read the list above. And this money isn’t just slush money, either—it is designed to fill the gap by ensuring that uninsured women who don’t qualify for Medicaid have access to family planning services. In other words, it is money paid for services rendered, much like Medicaid. Planned Parenthood isn’t the only recipient of this funding, either. In 2013, the government provided $278 million in Title X funding. Planned Parenthood received $60 million of that, or 22% of total Title X funding for that year.
Perhaps 22% sounds like a lot. I would point out that the reason Planned Parenthood received 22% of title X funding in 2013 is that the women Planned Parenthood serves tend to be low income. This is by design, because low income women frequently face the greatest barriers to contraceptive access. I would also note that while 22% is a sizable chunk, it’s still only just over one fifth. My point is that, just as with Medicaid reimbursements, Planned Parenthood is not receiving special preference in government funding. It is, rather, simply receiving the government funding any other health clinic providing the services it provides would receive.
Next time someone tells you that the government subsidizes Planned Parenthood, ask them to explain what they mean. Next time you hear someone say that we need to cut off Planned Parenthood’s government funding, ask them to desire what this funding looks like. The reality is that Planned Parenthood’s “government funding” is no different from the government funding your doctor or any other local health clinic receives. Defunding Planned Parenthood has nothing to do with the abortion rate. Instead, defunding Planned Parenthood would simply mean barring low-income women from receiving birth control, STD testing, and other health services at Planned Parenthood clinics. We need to stop playing politics with women’s healthcare—especially when those women are low income and have limited options for accessing healthcare to begin with.