The proposed American Health Care Act targets the health provider Planned Parenthood with a set of proposed limits on Medicaid payments to the organization.
Monday, the nonpartisan Congressional Budget Office confirmed the magnitude of those limits. The CBO found the Republican plan would reduce overall federal spending on reproductive care for women by $178 million in 2017. In all, it would block about $400 million in Medicaid reimbursements to Planned Parenthood each year, according to Jacqueline Ayers, the director of legislative affairs for the organization.
"The vast majority of our patients are on some kind of federal program," Cecile Richards, president of Planned Parenthood, told NPR's Ari Shapiro on Tuesday.
In all, she said, about 1.6 million patients receive health care from the organization each year through federal programs such as Medicaid.
"Planned Parenthood operates just like every other health care provider in this country that provides abortion services. We get reimbursed for preventive care," she explained.
"I guess if you want to reduce unintended pregnancy and the need for abortion, the last thing you should do is try to deny women the access to family planning," Richards said.
Tom Glessner, the president of the National Institute of Family and Life Advocates, which gives legal advice and other support to faith-based pregnancy clinics, is optimistic about the projected savings for the federal government.
"On the positive side, taxpayers benefit from this provision," he told NPR.
"Taxpayers would spend $156 million less, over a decade, by defunding Planned Parenthood, even if women used more Medicaid dollars during their pregnancies."
Glessner was referring to the increase in births the CBO projects if Medicaid patients are cut off from Planned Parenthood. The costs associated with about 45 percent of all births in the U.S. are paid for by the Medicaid program.
"In the one-year period in which federal funds for Planned Parenthood would be prohibited under the legislation, the number of births in the Medicaid program would increase by several thousand, increasing direct spending for Medicaid by $21 million in 2017," the CBO report notes.
The Republican plan technically cuts off funding to Planned Parenthood for only one year. If the organization stops providing abortions, it will be eligible for Medicaid reimbursements again. But Richards said there is no chance that will happen.
"We provide full reproductive health care for people in this country," she said. "And even though abortions may make up a small portion of what we do, women and families and young people come to Planned Parenthood because they count on us to be on their side, and to provide them with health care they need."
Federal spending on abortions is already illegal, except in the case of pregnancies that are the result of rape or incest or that threaten the life of the mother, as NPR has reported.
Republican lawmakers and some clinicians have said that if Planned Parenthood closes clinics, other health providers would try to take on those patients. But community health clinics say they are already overburdened.
The Republican plan currently calls for tens of billions of dollars for states to spend as they see fit, including on preventive care for women.
"How will the states use that money? They have great flexibility," Douglas Holtz-Eakin, former director of the Congressional Budget Office and current president of the conservative think tank American Action Forum, told Ari on Tuesday.
"They can give it to insurers as reinsurance for expensive patients; they can give it directly to individuals to cover out-of-pocket costs; they can create a variety of other programs like high-risk pools for expensive patients."
But Richards argued that spending would need to address a supply problem in rural or poor communities.
"The public health community has been abundantly clear that they cannot absorb the 2.5 million patients that Planned Parenthood sees each year," she said. "And particularly for women who have found a lump in their breast or need birth control immediately, and maybe a community health center can see them in a month or two months, that's not good enough."
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