Washington, D.C. Newsroom, Oct 22, 2020 / 05:00 pm (CNA).- Recent annual reports show that federal funding to Planned Parenthood has increased, despite efforts by the Trump administration to eliminate federal funding for the abortion provider over the last four years. One healthcare funding expert told CNA that without congressional action, new avenues of federal funding for abortion providers could soon be made available by pro-choice policy makers. 

While campaigning for president, Donald Trump made a series of commitments to pro-lifers in September 2016 that included “defunding Planned Parenthood as long as they continue to perform abortions.”

Planned Parenthood is barred by law from using federal funds—largely in the form of Medicaid reimbursements for services—to cover elective abortions. However, pro-life critics of the organization claim that federal dollars still allow the abortion provider to free up other resources for abortions.

Planned Parenthood’s overall revenue has gone up in recent years, from nearly $1.3 billion in 2014-15 to more than $1.6 billion in 2017-18 and again in 2018-19, largely through increased government funding and donations from the private sector.

“Private contributions and bequests” have increased from $353.5 million in FY 2015 to its peak of $630.8 million in FY 2018, before dipping slightly to $591.3 million for FY 2019.

Federal funding of Planned Parenthood affiliates increased from the 2018 fiscal year to the 2019 fiscal year, and has gone up overall since FY 2015.

In its annual report for the 2018-19 fiscal year, Planned Parenthood said its affiliates received more than $616 million in taxpayer dollars—a 9% increase from the $563.8 million total the year before, and a 13% increase from two years before.

Planned Parenthood affiliates mainly receive taxpayer dollars from “health services reimbursements” through Medicaid and Title X programs, Melanie Israel, a research associate in the DeVos Center for Religion and Civil Society at The Heritage Foundation, told CNA, although since 2019 abortion providers have been ineligible for Title X funding. 

The Trump administration has the authority to strip some federal funding from abortion providers, Israel told CNA, and has already done so through changes to the Title X family planning program.

In 2019, the Trump administration effectively boxed out Planned Parenthood from Title X funding by updating the requirements for recipients. Under the new rule, recipients of Title X grants must not be co-located with abortion clinics and cannot refer for abortions—requirements that Planned Parenthood clinics refused to abide by.

Rather than comply with the regulations, Planned Parenthood withdrew from the program in August of 2019. Since that act occurred after the end of the fiscal year, the forfeited revenue would not necessarily be reflected in the numbers in its latest annual report.

Democratic presidential nominee Joe Biden, for his part, has said he would reinstate the Obama administration’s Title X policy, allowing clinics who refer for abortions to once again receive Title X grants.

Planned Parenthood affiliates in some states are also the beneficiaries of state funding.

For example, Planned Parenthood of Northern California reported receiving more than $26.5 million from the state’s family planning office alone, in the 2020 fiscal year. It also reported more than $14.3 million in revenues from Medicare and the state’s Medi-Cal program, and more than $1.3 million in government grants.

Planned Parenthood affiliates also received as much as $150 million in emergency PPP loans earlier this year during the onset of the coronavirus pandemic—despite congressional stipulations that were intended to bar Planned Parenthood from the loans.

To limit federal funding of Planned Parenthood, the government can approve waivers for states to effectively block abortion providers from Medicaid funding, Israel said. 

The Trump administration has allowed states to refuse Medicaid funding of Planned Parenthood, reversing a 2016 Obama administration rule that said states could not do so simply on the basis of a recipient being an abortion provider.

But Israel said that in her view, Congress also needs to use its authority to strip federal funding from abortions in other areas through a broad ban on abortion funding—something it has not done yet.

Federal funding of elective abortions through Medicaid reimbursements is prohibited by the Hyde Amendment, a policy enacted into law regularly since 1976 as an attachment to annual appropriations bills for the Department of Health and Human Services.

The amendment is not permanent law, and Democrats have signaled their intent to reverse the policy— House Speaker Nancy Pelosi recently promised to not include Hyde protections in spending bills next year.

Some Congressmen have attempted to make Hyde protections more durable. Legislation authored by Rep. Chris Smith (R-N.J.) in 2017 and again in 2019 would make the Hyde Amendment permanent, and extend its protections to appropriations bills for all federal agencies. It would also forbid abortions at federal facilities, and block federally-subsidized health plans under the Affordable Care Act from covering abortions.

Members of Congress have also tried passing laws to fully defund Planned Parenthood. The House in 2017 barred Medicaid reimbursements at Planned Parenthood clinics in its major health care bill, but the legislation died in the Senate. The Senate in 2018 failed to pass an amendment by Sen. Rand Paul (R-Ky.) to defund the organization.

Amid the debate of how to defund Planned Parenthood, the number of abortions performed by the organization has gone up, even as the national abortion rate has declined, Israel said.

In the 2018 fiscal year, Planned Parenthood affiliates collectively reported performing 345,672 abortions—the organization’s highest number of abortions on record, she said. 

Meanwhile, the organization’s clients for contraception, prenatal services, and cancer screenings have all declined between 2006 and 2018, as documented in a recent Heritage report.