Republicans have been promising to cut Planned Parenthood's funding for decades, but whenever it actually came time to vote on it, the same cast of characters in the GOP would always side with Democrats to kill the bills. Every time, we would hear from leadership that the "timing simply wasn't right" to stop cut off the largest abortion provider on earth's access to Federal tax dollars.
President Trump ran on a promise that he would cut off Planned Parenthood's access to Federal funds, and this week, he did just that.
After the 9th Circuit Court of Appeals upheld his Protect Life rule, the Department of Health and Human Services informed all abortion clinics that they would no longer have access to Title X family planning funds unless they separate the healthcare part of their clinics from the abortion services.
But before we get too far, we need to explain how Planned Parenthood gets its funding.
There are two principle ways that Planned Parenthood and other abortion clinics get Federal funding. The first is through Medicaid reimbursement. Like any other clinic, when someone on Medicaid shows up to a Planned Parenthood for non-abortion services or treatments, their bill is run through Medicaid. The Federal government then pays out at the Medicaid rate, as would happen with any private health insurance plan. The bulk of Planned Parenthood's Federal funding comes through Medicaid reimbursement.
But the organization also has access to $280 million in Title X family planning grant money as well. Title X is a program designed to give clinics funds so they can provide cheap or free family planning services. These grants can be used for services directly, or for staff training or research programs. But the law states that Title X funds cannot be used to fund abortion procedures.
The Hyde Amendment states that it is against Federal law to provide any Federal funding for abortions. And yet, Planned Parenthood, the world's largest abortion provider, has found a way to qualify for these grants anyway.
The trick is how they manage their accounting. While the law states that Treasury funds cannot be used to fund elective abortion procedures, the law is silent on whether it can be used to prop up abortion providers by funding other services.
When it comes to an abortion clinic, these Title X funds could help them provide low-cost or even free contraceptives, but not abortion procedures.
This is a bit ridiculous, though. It is impossible to give an abortion clinic funding that contributes to that clinic's profitability without also facilitating abortion procedures. Let's say that Planned Parenthood needs to charge $100 to turn a profit on a medical procedure. If they charge any less, they will go out of business. But women in their communities can only afford to pay $50 for that procedure. If Planned Parenthood only takes in $50, they will go bankrupt. But with Title X funding, they can have it both ways. They can keep the lights on without having to overcharge customers because the Federal Government is paying for the bulk of the procedures.
This is what they call fungibility. The idea is that when you give an organization money, even if they have explicit restrictions on what they can use the money for, the grant frees up their resources to self-fund the non-approved services.
Here is an example. Suppose that your friend loses his job. He has a few hundred dollars in his bank account, but that is simply not enough to pay the rent. He turn to you and begs for help until he can find a new job. You generously agree to give him enough money to pay his rent every month as long as he only uses the money to pay the rent. The money can't go to anything else.
So, you give him the check and he uses it to pay the rent. But that still leaves him with a couple hundred that he already had in his account. On the way home, he stops at a store and buys a new flat-screen TV. When you go over to visit, you see the br new TV and flip out, accusing you of breaking your promise and using their money on frivolous things.
"Aha," you say. "That's not true. I paid my rent with your money and then used the money I already had in my account to buy a Television."
Technically, that is correct. If someone gives you money for one purpose and you use it for that purpose, then you comply with the stipulations. But by paying the rent, the friend's contributions freed up money that would have otherwise gone to living expenses.
That is the problem with funding Planned Parenthood's non-abortion side of the business. Even if the funds don't directly go to the abortion procedures, they allow Planned Parenthood to use its other funding to perform the procedures. It technically complies with the Title X restrictions, but violates the spirit of the law.
If Federal Funding allows an abortion clinic to turn a profit and stay in business, pay its abortionists' salaries, train their front-desk employees who schedule abortion procedures, and even directly fund other services necessary for an abortion to be performed (like a pregnancy test), can we really say that these funds aren't facilitating abortions?
President Trump's Protect Life regulation clarifies that funds that facilitate abortions are no different than funds that directly pay for abortions. If clinics like Planned Parenthood want to continue to receive this grant funding, then they would need to separate their abortion business from their healthcare practice.
To go back to the other analogy, it is perfectly fine for your friend to buy a television using his own funds, but he can't watch the TV in the house that you are renting for him.
For years, Planned Parenthood has claimed that abortion is just a small percentage of what they do. If that is the case, then this should be easy for them: Spin off their abortion business into a side entity and continue having access to Title X funds. But, that isn't what they're doing. They're digging in their heels and refusing to comply with the new regulations.
The result is really a win-win. If Planned Parenthood goes out of business, oh well. That $280 million will still be disbursed to non-abortion clinics and we will be rid of the largest abortion clinic on earth.
But if Planned Parenthood is able to survive without Federal funding, then it is also proof that they never needed it to begin with...