With Republican majorities in the House and Senate now sworn in and President-elect Donald Trump just two weeks away from taking the oath of office, Congress is geared up to follow through on their first promise to anti-abortion activists and defund Planned Parenthood. Knowing that the actual proposal to eliminate Medicaid reimbursements and other federal dollars from the health-care provider is still outrageously unpopular—yes, even among those who voted for Trump for president—the GOP believes it has a more palatable solution with a proposal that will only test-drive the idea by putting the funding ban in place for just one year. But as we’ve seen in other policy planks involving abortion, one year far too easily extends into another, and soon it's decades and longer.
The language that Republicans are expected to use in their defunding proposal will likely be identical to the resolution offered by Georgia Congressman Tom Price in 2015. Price—who is now slated to be the next Secretary of Health and Human Services—proposed H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act, which was vetoed by President Barack Obama. Included in the bill’s line-by-line repeal of every aspect of the Affordable Care Act is a section that bans federal funding for one year “whether made directly to the prohibited entity or through a managed care organization under contract with the State.”
It defines “Prohibited Entities” as “an entity, including its affiliates, subsidiaries, successors, and clinics … that is primarily engaged in family planning services, reproductive health, and related medical care; and provides for abortions, other than an abortion—if the pregnancy is the result of an act of rape or incest; or in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself.”
In other words, good-bye, Planned Parenthood.
Ending federal funding to Planned Parenthood has long been the dream of the anti-abortion movement, and one that has been just out of reach these past five years. From Lila Rose “stings” to alleged whistleblower claims of misusing Medicaid funds to the 2014 video “exposé” asserting that Planned Parenthood is selling fetal parts for massive profit, Republicans in Congress have consistently introduced a bans on funding based on every new manufactured outrage on the right. And almost always, the bills suggest eliminating funding for one year, usually so some type of “investigation” can occur.
If ousting taxpayer dollars from the health-care organization is such an important maneuver for the right-to-lifers, why do they only propose removing reimbursements for one year at a time? Because as the anti-abortion movement has learned from the past, a one-year moratorium is a highly effective foot in the door for decades-long change, and even potential permanent policy. The Hyde Amendment—the federal policy that forbids Medicaid reimbursement or other taxpayer-subsidized health-insurance plans from covering abortions except in the most limited of cases—has been renewed annually for over 40 years now. Often, the biggest debates over renewal are whether a rape victim should be allowed to use their insurance to terminate or be made to pay out of pocket—and whether she should be forced to carry to term and give birth.
As history shows, once an abortion policy is put into effect, it’s far likelier to stay in effect than it is to get ousted. That was just one of the reasons that activists worked so hard during the last election to make repealing Hyde a campaign priority. Abortion opponents responded to the push by claiming Hyde was settled, bipartisan-supported policy, and argued that allowing poor people to use Medicaid to pay for pregnancy terminations was a form of “abortion extremism.” With four decades of abortion-coverage bans, making most low-income pregnant people pay out of pocket for abortions is now sadly considered status quo, and one that anti-abortion activists now hope to codify permanently within the next few years.
Looking at the Congressional history of the Hyde Amendment shows the clear path that social conservatives are starting down in an attempt to permanently defund Planned Parenthood. Their hope is that a one-year policy will be more palatable for the Republican caucus, some of whom—like Senators Susan Collins of Maine or Lisa Murkowski of Alaska—have been concerned in the past about the impact such a move could have on services for lower-income and uninsured constituents. Because the GOP has such a slim majority in the Senate, they need almost every member to be on board in order to push a defunding resolution through.
They also hope claiming that this is a small break, not a permanent action, will appease their own voters, many of whom cast ballots for Trump but now say they are outraged that a Planned Parenthood defunding vote is actually on the docket. According to Huffington Post, post-election focus groups of Trump voters said that they would “surprised,” “frustrated,” “misdirected,” “disappointed in the democratic system,” and “pissed off as hell,” if the entity lost its reimbursements, despite the fact that their future president told them stripping funding was exactly what he planned to do.
Have no doubt about it: Passing a one-year ban is just the first step in their blueprint for permanently closing Planned Parenthood. They expect that during that first year there will be little impact, as direct donations to the organization will increase as a result of the Congressional move. Then they will point to the lack of adverse effects on patients as a sign that Planned Parenthood could easily meet patient needs through private donations rather than any taxpayer dollars, and renew their ban for another year. Eventually, just as with the Hyde Amendment, they will either seek to make it permanent or argue each year that it is settled policy and renew it automatically. And as outside donors eventually dry up because health-care needs can never be effectively met only through private funding, clinics will slowly close their doors.
Of course, this can only work if the public allows it. The anti-abortion movement relies on an assumption that Americans have no long-term memory for policy battles. The right believes that a new, more immediate threat will distract us, or that we will grow too tired of continuing to be outraged and simply give up on the fight. They are playing the long game in the hope that eventually we will wear down, even if it takes 40 years or longer as it has with Hyde.
But 40 years later, we still haven’t given in on Hyde, and we won’t give in this time, either.