The Nebraska legislature voted Wednesday evening to deny federal family planning funds to Planned Parenthood of the Heartland, inching closer to a conservative goal to defund abortion providers.
Lawmakers voted 44-4 to advance a main budget bill that excludes providers associated with abortion from the federal Title X program.
The amendment to the budget bill is viewed as a compromise among Nebraska lawmakers. Previous language passed — which was first proposed by Gov. Pete Ricketts (R) — blocked federal Title X funding to any clinic that performs, counsels, or refers abortion services. This would have jeopardized some community health centers’ federal dollars as they refer abortion services. The amendment’s revised language now says “pregnancy termination or referral for an emergency situation… shall not constitute a referral for abortion” — and this presumably safeguards all but Planned Parenthood, Nebraska’s only current Title X participant that performs abortions.
But the exception for an “emergency situation” is very dangerous and can have a chilling effect on other current Title X clinics who provide abortion referrals, said National Health Law Program (NHeLP) Reproductive Health Director Susan Berke Fogel.
“The governor won,” said state Sen. Ernie Chambers (D) after the legislature moved forward on the budget bill.
Should the Nebraska legislature pass a budget with these anti-choice restrictions, it would be the first immediate attack following the Trump administration’s April 2017 guidance, which effectively encouraged states to exclude Planned Parenthood from Title X funding.
This is the second year in a row Gov. Ricketts has tried to disqualify abortion providers from the federal Title X program. When he tried to do so last year, he failed earlier on in the budget process.
Planned Parenthood of the Heartland is rallying against the passage of the budget bill as written because 8,000 Nebraskans who go to them depend on this money for health care.
“Governor Ricketts has aligned himself with the Trump-Pence administration, and it is clear he will do anything in his power to take away basic rights from women,” Planned Parenthood of the Heartland said in a statement.
Title X is the only federal family-planning program dedicated to offering reproductive health care to low-income people, and Planned Parenthood is a major recipient nationwide. These are competitive grants and the Nebraska health department is the primary grantee. Thirteen providers in Nebraska receive these federal dollars, including the Planned Parenthood affiliate which sees nearly one-third of the 28,000 patients served by this funding. This money goes to breast exams, pap smears, and birth control but is not used for abortion services.
Nebraska lawmakers may be running afoul of Title X federal law by excluding Planned Parenthood. “While Title X says that no Title X funds can be used for abortion, to suggest that means that a facility receiving Title X funds cannot also do abortions with other funding is a distortion of the federal statute they are citing,” NHeLP’s Fogel told ThinkProgress. Rescinding guidance doesn’t change Title X statutes and regulations and is a “dangerous precedent” to set, she said.
ThinkProgress reached out to other current Title X grantees in Nebraska to see whether they’ll be able to care for Planned Parenthood’s patients should the provider be excluded from the program, but did not immediately hear back. A recent Kaiser Family Foundation national survey found less than one in five clinics said they could increase their patient caseload by more than a quarter next year, suggesting it’ll be a challenge to fill Planned Parenthood’s void.
“An attack on just one provider type will have serious ramifications for many other providers across the state of Nebraska,” said Audrey Sandusky, director of advocacy and communications for the National Family Planning and Reproductive Health Association (NFPRHA), which represents some Nebraska subrecipients. “Without Title X funding, health centers could be forced to significantly cut back on services, staff or even close.”
Wednesday’s vote comes after two failed attempts and a missed budget deadline. Nebraska’s legislature is unicameral, but one more vote is required before the bill heads to the governor’s desk. A budget needs to be finalized before the end of the legislative session on April 18.
CLARIFICATION: This piece was updated to clarify that Nebraska’s budget would be the first direct attack since the Trump’s April 2017 guidance. Nebraska is not the first state to have passed legislation targeting Planned Parenthood since the guidance.