Senate Republicans Try to Defund Planned Parenthood in Health Care Bill Gamble

Updated | Senate Republicans have decided to gamble with their health care bill over defunding Planned Parenthood.

In a draft released Thursday morning, GOP leaders included language that would bar states from channeling federal Medicaid funding to any health care provider that provides abortions (unless the procedure is required to protect the health of the mother or she is a victim of rape or incest) for one year. The bill doesn't specify Planned Parenthood, the country's largest abortion provider, but its target is clear. Each year, the reproductive health organization receives millions of dollars in Medicaid-funded state grants to provide reproductive health services to mainly low-income women. According to the Congressional Budget Office's assessment of the House health care bill, which includes identical language on Medicaid funding and abortions, "only Planned Parenthood Federation of America and its affiliates and clinics would be affected" by the provision.

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Planned Parenthood does not receive federal money that goes toward abortions—that is already prohibited. But social conservatives have been pushing for years to cut the organization off from all federal funding, arguing the public money the group receives to cover things like cervical and breast cancer screenings and STD tests frees it to use other sources of income to promote abortion services. Not everyone agrees with this approach, however. Two Senate Republican swing votes—Alaska's Lisa Murkowski and Maine's Susan Collins—have publicly criticized the defunding proposal, which was also included in the House health care bill that passed in early May. If Senate Republicans lose those two women's votes, they would have have to win over every other Republican senator to get to the 50 votes needed to pass their bill. And several conservatives are also on the fence, for unrelated reasons.

But the bigger problem Senate Republicans may face by including the Planned Parenthood language is a procedural one: The provision may run afoul of Senate rules. GOP leaders are tyring to move their bill through the chamber under a process known as "reconciliation," which allows them to avoid a Democratic filibuster. But under that process, legislation has to stick very strictly to budgetary issues, not any other "extraenous" policies. Planned Parenthood is already out with a statement declaring the Senate draft breaks those rules. "Experts agree the 'defund' Planned Parenthood provision is a violation of the Byrd Rule because it is politically-motivated policy," the group asserted.

A senior Republican Senate aide conceded Thursday that the authors of the bill are unsure if the Planned Parenthood provision will pass muster with the Senate parliamentarian, a nonpartisan official who has the power to deny the majority's bid to consider the rules under reconciliation. Without reconciliation, Democrats can blockade a vote on the legislation unless Republicans can win 60 votes (which is not going to happen). "There will be ongoing conversations with the parliamentarian," one aide told reporters Thursday afternoon. "I'm not prepared to say today what her opinion might be."

The story has been updated to reflect the Congressional Budget Office's analysis of the impact of the abortion provision in the House and Senate health care bills.