When Jeb Bush said he wasn’t sure “we need a half a billion dollars for women’s health issues” before a Southern Baptist gathering on Tuesday, even conservatives cringed.
“Isn’t one benefit of an establishment candidate supposed to be that he’s not going to make gaffes like this?” senior writer at The National Review John McCormack tweeted.
“A few more months of this and the GOP will be wishing for a candidate with the political skills of Mitt Romney,” tweeted former Obama adviser Dan Pfeiffer.
Bush later said he “misspoke” on stage, and that what he meant was that “there are countless community health centers, rural clinics, and other women’s health organizations that need to be fully funded.”
But is Bush’s claim that Planned Parenthood, and women’s health care generally, is receiving too many government dollars actually that different from the rest of the Republican field?
The legislation to defund Planned Parenthood has received broad support from the nine other Republican candidates who will appear on the first debate stage Thursday night. Senators Ted Cruz, Rand Paul, and Marco Rubio all voted in favor of a Senate bill to exclude Planned Parenthood from receiving federal funding. Gov. Scott Walker has boasted about already defunding Planned Parenthood in Wisconsin (a somewhat dubious claim, as the funding streams are complicated), as has New Jersey Gov. Chris Christie and Ohio Gov. John Kasich. Former Arkansas Gov. Mike Huckabee called the Senate’s failure to advance the defunding bill “salt in a sick, grotesque wound.” Ben Carson, who earned notoriety as a respected neurosurgeon, said Congress should “eliminate every last dime” of Planned Parenthood funding.
Trump has perhaps gone the furthest of all, saying that withholding funding from the women’s reproductive health organization is so important the government should be shut down until it is.
By saying they want to defund the women’s health organization, Republicans are setting up a false dichotomy between Planned Parenthood and community health centers. The two tend to work best together, rather than against one another.
The idea that there are “countless” under-funded community clinics that are just waiting to get money that is otherwise sucked up by Planned Parenthood is a misunderstanding of how the women’s health organization is funded. It receives both federal grants dedicated to family planning under Title X and Medicaid reimbursements for health care services. The bill the Senate voted on this week appears to try to cut Planned Parenthood off from both, even though current federal law says the government can’t discriminate among qualified Medicaid providers.
“Title X grants are funded through competition. Grants are awarded to both states and nongovernmental organizations that demonstrate strong capacity to provide high-quality family planning and other preventive health care, with priority given to low-income and underinsured women and men,” said Clare Coleman, President & CEO of the National Family Planning & Reproductive Health Association. “According to federal data, in 2013 Planned Parenthood affiliates participating in Title X saw 37% of all patients served nationwide. If Planned Parenthood were to be defunded, it would disrupt and, in some states, dismantle the Title X family planning program.”
“We cannot know exactly whether and when other providers could step up and fill in that gap of services that Planned Parenthood provides. But we do know that they serve about a third of all clients that obtain care from publicly funded planning centers, and that’s more than any other type of provider,” said Kinsey Hasstedt, public policy associate at the Guttmacher Institute, a nonprofit that studies the policies of women’s reproductive health care.
If Congress did manage to pass a bill blocking Planned Parenthood from receiving any government funding, it would be entirely unclear how more than a million women would obtain similar care.
Hasstedt said that in Texas, which severely limited funding to Planned Parenthood, health care access for low-income women suffered dramatically. She pointed to a recent study by George Washington University that found Texas’ limitation of funding to Planned Parenthood would result in long wait times at community health centers, less comprehensive contraceptive options for clients, and and potentially increased costs to clients. Planned Parenthood providers are also far more likely to also be able to provide contraceptive services on site, which can be a huge help for low-income clients who have trouble getting off work or struggle with transportation to multiple health care locations.
“You wouldn’t go to an OB-GYN if you had a broken arm,” she said, so it’s unfair to ask community clinics to take on the specialties that Planned Parenthood has been comprehensively providing.
Now, the idea of whether women can visit a Planned Parenthood clinic at all has become part of the ideological debate. “I think it’s really unfortunate that we have now for years, a heightened ideologically driven attacks on women’s health care and women’s health care providers to family planning services,” Hasstedt said.