How the Trump Administration Can Beat Planned Parenthood

President Trump has proven himself to be a man of his word on a whole host of important issues, not least of which is his outstanding record on pro-life matters.  He can now achieve a great pro-life milestone by putting additional substantial limits on federal funds intended for Planned Parenthood and other abortion-providers in a manner that would likely stand up to judicial scrutiny.

President Trump's pro-life accomplishments include redirecting Title X family planning funds away from abortion-providers, effectively depriving Planned Parenthood of up to $60 million annually.  He also reinstated and expanded the Mexico City Policy, effectively protecting over $8.8 billion in overseas aid from funding abortion.  Among his other accomplishments are his appointments of pro-life federal judges and allowing states to defund Planned Parenthood of Medicaid money.

The time is now ripe to redirect remaining non-Medicaid federal funds from Planned Parenthood and others who offer elective abortions.  Perhaps some of these funds can be diverted to further support and expand the myriad of Federally Qualified Health Centers (FQHCs) located throughout the country.

These health centers are funded by the government and are run under the HRSA (Health Resources & Services Administration)'s Health Center Program.  They help serve medically underserved communities, providing comprehensive primary and preventative care, but do not provide abortions.  As of August 2018, there were approximately 1,400 health centers operating about 12,000 service delivery sites in every state and in Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin, servicing over 27 million people, or 1 in 12 Americans.  These sites service 1 in 5 rural residents and 1 in 3 people living in poverty.

In contrast, there are currently 611 Planned Parenthood health centers in the U.S., which, according to the Planned Parenthood's 2017–2018 Annual Report, service approximately 2.4 million patients.  To put this into perspective, there are over eleven times as many patients who go to close to twenty times as many FQHCs as compared to Planned Parenthood patients and locations, respectively.  In 2015, the Charlotte Lozier Institute produced stunning maps that show FQHC and Planned Parenthood locations, further highlighting how much more accessible FQHCs are.

In light of this, it is apparent that aside from the preponderance of the FQHCs, redirecting funds will also represent a big step toward freeing pro-life Americans from indirectly funding abortions at Planned Parenthood (and other abortion-providers) with their non-Medicaid federal tax dollars.  Since money is fungible, every taxpayer dollar that goes to Planned Parenthood, supposedly for non-abortion services, frees up another dollar that Planned Parenthood receives — for instance, from private donations — to directly fund abortion.

The fight against federal funding of abortion would be a winning campaign issue for President Trump.  According to a 2018 Gallup poll, about 53% of Americans said abortion should be legal in only a few circumstances (35%) or never (18%) as compared to 43% who said abortion should be legal in all or most circumstances.

While reallocation of Medicaid funds from Planned Parenthood to FQHCs is not a new idea, it can serve as a basis for an executive order that reallocates non-Medicaid funds in a manner significantly more likely to survive a court challenge than reallocation of Medicaid funds.  Diverting Medicaid (Medicare and CHIP) funds away from abortion providers such as Planned Parenthood, while laudable, may or may not be feasible (with some appeals courts still leaning liberal) until the Supreme Court has one or two additional conservative judges and more conservative federal judges are appointed to appeals courts.

Even withholding non-Medicaid federal funds still poses a risk that activist judges would try to curtail President Trump's authority even outside of Medicaid funding.  However, withholding Medicaid funds poses a greater risk.  For instance, while the U.S. Court of Appeals in Ohio ruled in favor of states withholding funding from Planned Parenthood and other abortion-providers, appeals courts in Colorado and Louisiana ruled against Kansas and Louisiana withholding Medicaid funds from abortion-providers.  (The Supreme Court narrowly refused to hear that case last December.)  However, as President Trump appoints more conservative federal judges, fully defunding abortion-providers may become feasible in the foreseeable future.

While Medicaid (and Medicare) funds certainly constitute a significant majority of federal taxpayer dollars that fund Planned Parenthood, a large portion of government money comes from various departments within the government.  While in their annual reports from F.Y. 2013, F.Y. 2014, and F.Y. 2015, Planned Parenthood reported receiving a total of $1.6227 billion in government funding (federal and state), a U.S. Government Accountability Office (GAO) report released in March 2018 noted that Medicaid funds received by Planned Parenthood from F.Y. 2013 through F.Y. 2015 totaled $1.213 billion (while Medicare and CHIP totaled $2.81 million).  This means that during this period, about $407.11 million of these federal funds were from sources other than Medicaid (and Medicare or CHIP).

Assuming that the federal portion of Medicaid constitutes 57% of the total, the federal government spent about $691.28 million on Medicaid during that period out of a total of $1.101 billion.  In other words, an estimated 37% of federal funds from F.Y. 2013 through F.Y. 2015 that went to Planned Parenthood came from sources other than Medicaid, Medicare, or CHIP.  Since total government funding for Planned Parenthood in F.Y. 2018 was higher than any years covered in the GAO report, it is evident that Planned Parenthood continues to receive a large sum of money outside Medicaid funds that the Trump administration can still reallocate. 

The GAO report also notes that Title X family planning funds constituted at least $171.81 million (or 15.6%) of all federal funds that went to Planned Parenthood during those years.  President Trump's executive order (known as the Protect Life Rule) cutting off Title X funds from abortion-providers leaves about 20% remaining that can be stripped from Planned Parenthood outside Medicaid funding.

According to the GAO report, from F.Y. 2013 to F.Y. 2015, HHS (the Department of Health and Human Services) reported federal obligations totaling $89.69 million, while Planned Parenthood had reported expenditures of federal funding from the departments of Agriculture, Homeland Security, Housing and Urban Development, and Justice of $16.37 million.  The top 10 HHS-funded programs in terms of Planned Parenthood expenditures from of F.Y. 2013 through F.Y. 2015 resulted in $246.4 million of expenditures (as well as an additional $9.6 million spent from another 27 HHS programs), with total expenditures of 288.88 million.

It should be kept in mind that Planned Parenthood has a record of defrauding the federal government, therefore it is imperative that the government investigate and audit Planned Parenthood.  For instance, in August 2013, Planned Parenthood paid out a $4.3-million settlement in a lawsuit for billing the government for services that were not medically necessary, as well as services not even provided.  According to Planned Parenthood annual reports, there has been a 30% decline in contraception-related services and a 45% decline in cancer screenings and prevention services from F.Y. 2013 to F.Y. 2018, beginning around the time of that settlement.

President Trump and the Trump administration have been true leaders in the fight for life and have proven so in word and in deed.  The time is ripe to achieve another major pro-life victory by denying Planned Parenthood (and other abortion-providers) a substantial chunk of federal funding.