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Patients come to Planned Parenthood because of the high-quality care and commitment to their health and well-being—regardless of their circumstances or income. Planned Parenthood intends to be there for them for the long haul regardless the hurdles law-makers put in front of them.

ACA Repeal and Replace

Since the election, as expected, the multitude of attacks on health care have been never ending. The United States House of Representatives passed a bill to repeal and replace Obamacare in the Spring that would have resulted in millions of people losing health insurance and would have blocked more than 28,000 Planned Parenthood patients from getting their health care at their provider of choice.

The United States Senate tried, and failed, three times to do the same. They failed because supporters from Minnesota and across the country made phone calls, sent emails, signed petitions, and spoke out--making it clear these devastating bills should not become law.

Anticipated Congressional Defund Attempts

Despite the incredible victories, Congress is expected to continue their efforts to dismantle health care and “defund” Planned Parenthood from a variety of federal funding streams. This specifically includes attempts to prevent Planned Parenthood from being reimbursed for the health care services provided to patients who have Medicaid as their insurance and attempts to defund Title X.

The next significant defund threat could come through the budget reconciliation process, which requires only 51 votes to pass. The first reconciliation bill will be tax reform, which Congress is currently working on, and is expected to include a Medicaid defunding measure. Through this tax reform reconciliation process, Senate Republicans could pass a measure to defund Planned Parenthood without needing a single Democratic vote. The timeline for this is uncertain, but it could occur as early as next month.

As a reminder – Planned Parenthood does not get a blank check from the federal government. “Defunding” simply means patients who rely on Medicaid or Title X to access services would not be able to go to Planned Parenthood clinics for birth control, lifesaving cancer screenings, STD testing, or annual exams. For patients on Medicaid, Planned Parenthood is reimbursed for services just like any other provider in the country.  If Planned Parenthood is defunded from Medicaid, 24,000 people in Minnesota and hundreds of thousands around the country that rely on them would lose access to care.

Title X is a 45-year-old federal grant program that offsets the cost of birth control and other family planning services for Planned Parenthood’s neediest patients.  Title X is an important source of safety net funding for uninsured and rural Minnesotans. More than half of Minnesota’s rural counties have been designated as a health care professional shortage area due to inadequate number of primary care providers. Without Title X funding rural Planned Parenthood clinics are threatened--further exacerbating rural people’s ability to access reproductive health care.

We are relying on our allies in Congress to work with us to fight back on these attempts to defund Planned Parenthood from Medicaid or Title X and relying on the same grassroots support that stopped the ACA repeal to stay strong as these threats continue.

Even more sinister than the Congressional attacks on Planned Parenthood and reproductive health care are the ways the Trump Administration is unilaterally using its executive and administrative powers – away from the public eye - to institute policies that will harm women.

From lining the halls of the Department of Health and Human Services (HHS) with anti-choice appointees to charting a policy vision that defines life as beginning at conception, Trump has made it clear that he will cater to anti-abortion extremists and his radical right wing base.

HHS Strategic Plan

Anti-abortion activists have a powerful ally in the Trump Administration, which has placed anti-abortion and anti-birth control extremists in key leadership positions within the Department of Health and Human Services, the federal agency in charge of protecting and promoting the health of Americans. Now, those same extremists have set a policy vision for HHS that defines life as beginning at conception and are emphasizing preserving religious freedom over improving public health.

HHS Appointees

For instance, the Trump Administration appointed Charmaine Yoest to serve as Assistant Secretary for Public Affairs at HHS. She used to lead the anti-abortion group Americans United for Life and helped develop the Texas law that shut down the majority of women’s clinics in the state. She believes that condoms do not protect against HIV or other STDs, has claimed contraception does not reduce the number of abortions and has linked abortion to breast cancer, despite all the evidence to the contrary.

Brian LeClair, a former Minnesota State Senator and policy advisor to Gov. Tim Pawlenty and has been appointed to lead a branch of HHS that focuses on improving health care for vulnerable people. Years ago, LeClair led an unsuccessful effort to stop the opening of Planned Parenthood’s clinic in Woodbury, Minnesota and is an ardent opponent of women’s access to abortion.

Now these people - surrounded by numerous other equally terrible Trump Administration appointees - are deciding how billions of dollars in family planning and Medicaid dollars will be used. These are not the types of people who should be setting policy that impacts the lives and health of millions of people across this country.

Birth Control Mandate

The power of these anti-abortion appointees – and the influence they have over the current administration – is on full display in HHS’s recent rule that allows ANY employer to stop covering birth control in employee insurance plans for religious or moral reasons. The new “moral” exemption was specifically drafted by HHS to cater to the Washington DC-based March for Life and the Pennsylvania-based Real Alternatives, a crisis pregnancy center. Both are anti-abortion groups that would not otherwise qualify for religious exemptions. Now, thanks to their contacts in the Trump Administration, the new morality clause allows them to opt-out of contraceptive coverage on vague moral grounds.  

The ACA’s birth control mandate rule has been working: in its first year alone, the birth control mandate saved women an estimated $1.4 Billion in out-of-pocket spending on birth control. The birth control mandate is a true public health victory, where women can freely access the birth control method that works for them, free of cost-sharing obligations or government interference.

This new rule is totally unacceptable and jeopardizes access to free birth control for 62.4 million women. President Trump wants to make birth control about ideology, but let’s be clear: For women and their families in the 21st century, birth control is about being healthy and financially secure—and that’s why we, along with our allies, are going to keep fighting back against his shameful attacks on women with this bill and any other way we can.

There are also a number of other policy developments that haven’t happened yet, but that  might be coming.

Redefining “Preventive Care”

In addition to the rule allowing any employer to opt out of contraceptive coverage, the Trump Administration also has the power to unilaterally exclude birth control from being considered ‘preventive care’ under the ACA. That definition change would mean women would go back to the days of paying out-of-pocket for birth control – when women typically spent 30-44% of their total health care spending on contraceptives - effectively limiting access and the ability to freely choose the method that works best for them in the process. Given all of the birth control opponents lining the halls of HHS, whom would be responsible for a change like this, a move to carve contraceptives out of the preventive care bucket is anticipated.

Domestic Gag Rule

The Trump Administration could also issue a new policy – or a gag rule – designed to block Planned Parenthood and other abortion providers from receiving Title X dollars. Title X is the 45 year old federal family planning program that enables low-income Americans to access family planning services at clinics across the country, including Planned Parenthood. HHS could unilaterally issue this gag rule and force providers to choose between providing abortion care and receiving Title X funds. This is a choice Planned Parenthood should not be forced to make.

Tags: minnesota

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