The United States Congress is trying hard to defund Planned Parenthood, once and for all. For a period of one year, the proposed American Health Care Act would prohibit federal funds from going to non-profit organizations that provide family-planning services, including abortions, and get more than $350 million in reimbursements under Medicaid, which provides health insurance to the poor, the elderly, children, pregnant women, and people with disabilities. When the Congressional Budget Office evaluated this clause of the bill, it “identified only one organization that would be affected: Planned Parenthood Federation of America and its affiliates and clinics.”
Dispatches from the Aspen Ideas Festival/Spotlight Health
If this bill goes through, it would represent an existential threat for Planned Parenthood. The organization would be less able to serve poor women who are covered by state Medicaid programs, and it would likely have to close clinics or reduce its services because of the loss of funding. The main motivation behind this provision—and others like it that have come up at the state level—is opposition to abortion. This has lead some, including Ivanka Trump, to wonder why Planned Parenthood doesn’t just spin off its abortion services into a separate organization.
Cecile Richards, the organization’s president, will have no such thing. “The minute we begin to edge back from that is the minute that they’ve won,” she said during an interview at the Aspen Ideas Festival on Monday. Despite the renewed push in Washington to stop the organization from getting government funding, Richards believes Planned Parenthood can win the culture wars and make abortion widely acceptable in America. “We’ve got to quit apologizing or hiding,” she said.
Technically, the federal government already prohibits funding for most abortion services. Under the so-called Hyde Amendment, first passed in 1976, organizations like Planned Parenthood can’t get reimbursed by Medicaid for performing elective abortions. But pro-life advocates often argue that Hyde doesn’t go far enough. Since Planned Parenthood can get public money for some of the other services it provides, taxpayer dollars still effectively go to fund abortions, they say.
This characterization is “completely inaccurate,” Richards said. Other health-care organizations, including many hospitals, provide abortions, she argued, and they, too, get reimbursed under Medicaid for their other services. “Somehow, Planned Parenthood is being held to a completely different standard,” she said.
Richards believes the political discourse around abortion has become toxic in recent years. “There was a time when the Republican Party embraced individual liberties,” she said. “In fact, many of our Planned Parenthood affiliates were founded by Republicans.” While more Republicans used to consider themselves pro-choice, she said, their ranks have been significantly been reduced—Richards name-checked Maine Senator Susan Collins and Alaska Senator Lisa Murkowski as the only two left in the Senate.
“We’ve got to pull the curtains back and be open and honest about this procedure.”
Even in the face of so much opposition, Richards isn’t willing to have Planned Parenthood separate abortion from the rest of its health-care services—quite the opposite. She believes Planned Parenthood can and will win the culture wars to end “the stigma of abortion.”
“It’s more important than ever that we stand loud and proud for the ability of any woman—regardless of her income, her geography, her immigration status, her sexuality, her sexual orientation—to access the full range of reproductive health care,” Richards said. “We’ve got to pull the curtains back and be open and honest about this procedure that one in three women will have at some point in their lifetime, and their right to make that decision.”
Richards cited the way pop-culture depictions of abortion have changed in recent years. “I’ll shout out Teen Vogue and Cosmo and Glamour—women’s magazines that are putting abortion stories into their magazines. That’s never happened before,” she said. Or abortion will show up on television: Shonda Rhimes, who recently joined Planned Parenthood’s board, featured abortion in an episode of Scandal, “dealt with not in hysterical terms,” as Richards put it.
Richards repeatedly claimed that “the vast majority of people in this country believe that abortion should be safe and legal,” and “that’s even more true today than it’s ever been.” The available polling does not necessarily back up this assertion. As of 2016, about 57 percent of American said abortion should be legal in all or most cases, according to Pew Research Center—a level that has been roughly consistent over the past two decades, and slightly lower than what polls on this issue found in 1995.
Gallup found that half of Americans said abortion should be legal “only under certain circumstances” in 2016, and that 46 percent of Americans identify as pro-life. The numbers also don’t differ radically by generation: According to Pew, between 37 and 42 percent of all age groups said abortion should be illegal in all or most cases in 2016.
“I’ll fight until the end of my days for every woman to make that decision themselves.”
Richards sees the recent legislative efforts to end funding for abortion as the first battle in a long war. “A cautionary tale: These folks aren’t just against Planned Parenthood,” she said. “They’re against birth-control access. … Anyone who thinks that … if we didn’t provide abortion services, somehow, they would quit this attack on women—I’m sorry. It’s just the beginning.”
Her answer is to commit to abortion: to stop “hiding,” de-stigmatize it, and most of all, keep performing the procedure. “Having been pregnant myself, my children are the joy of my life,” she said. “But that was my decision to make. And I’ll fight until the end of my days for every woman to make that decision themselves.”
According to the Congressional Budget Office, the people most likely to be affected by the AHCA’s one-year ban on reimbursement for family-planning services have low incomes and live in areas without a lot of health-care options. About 15 percent of this population would lose access to reproductive-health care, the CBO projected. Despite Richards’s confidence, a clear majority of the House has voted to defund Planned Parenthood. If the Senate follows its lead, the organization will struggle to survive.