Two female Senate Republicans could stop the anti-abortion movement from achieving its most significant win against Planned Parenthood in decades.
Most Republicans want to eliminate the group’s $555 million in federal funding as part of their bill to repeal Obamacare. But as Majority Leader Mitch McConnell tries to solve the legislative Rubik’s Cube of finding 50 votes for repeal, he may have to drop the Planned Parenthood cut to win the support of the two Republican moderates, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska.
The problem is, McConnell would then face the wrath of the anti-abortion community — and its supporters within the Senate. Several prominent anti-abortion groups warned Thursday in a letter to the Senate that they would oppose a bill that doesn’t cut off funding to Planned Parenthood and prohibit insurance subsidies from covering abortion.
“We have a strong pro-life majority in the Senate, and so it’s going to be in there,” said Sen. John Cornyn of Texas, the No. 2 Republican in the Senate.
The debate over using the repeal bill to eliminate funding for Planned Parenthood is one of a half-dozen issues that have threatened to divide the Republican conference and prevent them from achieving their long-term goal of repealing the health care law.
Planned Parenthood is blunt about the consequences of such a cut. “People will lose access and women will die,” said Executive Vice President Dawn Laguens. “Thousands of women have had their cancer and precancerous conditions discovered by Planned Parenthood. There are not enough places for women to go to get this care.”
But how many Republicans may be willing to stake their vote for Obamacare repeal on the bill’s inclusion of Planned Parenthood cuts is unclear.
Sen. Marco Rubio (R-Fla.), a prominent opponent of abortion, said he isn’t ready to go that far.
“I’m always looking for an opportunity to do what’s right on that issue,” Rubio told POLITICO. “But that said, I would say that my focus right now is on the broader health care marketplace, getting it fixed. Certainly, if it has that in there, it would be something I’d be supportive of. Whether I condition my vote on it is not something I’m prepared to say.”
The question is how many lawmakers would make a similar calculus.
The fate of funding will likely be determined by whether McConnell needs the votes of Collins and Murkowski. To pass the repeal under the fast-track budget procedure, he requires support from 50 of his 52 Senate Republicans, assuming Vice President Mike Pence casts a tie-breaking vote. If every other Republican backs the bill, McConnell won’t need the two moderates.
But even before the bill is written, other possible defections are emerging.
Sen. Rand Paul (R-Ky.) has voiced strong opposition to the provisions discussed so far, trashing the legislation for keeping “90 percent” of Obamacare. Other conservatives could follow. Or, moderates could balk at the big cuts to Medicaid.
Murkowski has repeatedly said she doesn’t think zeroing out Planned Parenthood’s funding should be part of the repeal bill. “I don’t think that it should even be part of the discussion about health care,” she said.
However, she has not gone as far as saying she would oppose a bill that includes it.
Collins has been more emphatic. She opposes cutting Planned Parenthood, but the federal funding is just one of several concerns she has with the Obamacare bill.
Every other Republican has supported eliminating funding in the past. Sen. Dean Heller (R-Nev.), perhaps the most vulnerable Republican up for reelection in 2018, said at an April town hall meeting that he wants to “protect” Planned Parenthood, but later said he opposes funding if the organization performs abortions.
The 2015 Obamacare repeal bill, which Republicans crafted as a dry-run for repeal if a Republican president was elected, included defunding of Planned Parenthood. Murkowski and Collins supported an amendment to strike the provision, but it failed. Murkowski still voted for the bill, but Collins did not.
“Everything is going to be trying to get to 50,” said Sen. John Thune (R-S.D.), a member of Senate leadership. “The people who are opposed to having that provision in the bill, I’m sure there will be discussions with them to figure out what it will take to get the vote.
“But we’ve got individual members who have issues with a lot of different features in the bill. So putting together the strategy that gets us to 50 is no doubt going to be a challenge.”
Last year, Planned Parenthood got $555 million in government funding. The organization has said the majority of that money is reimbursements for health services provided under Medicaid, which prohibits funding abortion except in cases of rape, incest and the mother’s health.
Laguens said that if Planned Parenthood loses a half-billion dollars, it would likely have to close some facilities or reduce services.
“There is no way Planned Parenthood could fundraise to be the public health safety net in this country for low-income women,” she said.
Republicans say they would take the federal funding that now goes to Planned Parenthood and divert it to community health centers, which they say are more accessible to certain groups; for instance, people in rural areas. Planned Parenthood argues that most community health centers don’t provide the women’s health services they do — and that Medicaid recipients should be able to choose the best health care provider for them.
Planned Parenthood and Democrats say they would do everything they could to make defunding — and repeal of the Affordable Care Act overall — huge political issues in the 2018 election, forcing Republicans to defend their decisions to take health care away from vulnerable populations.
“Particularly swing states — Arizona, Nevada, Colorado — those are the kind of states” where defunding would be a vulnerability, Laguens said.
But anti-abortion groups, which are influential with many conservatives, say the issue is just as important for them.
If the cut is not in the bill, “it would be time for a very serious conversation,” warned Catherine Glenn Foster, president and CEO of Americans United for Life, which opposes abortion. “I expect it to be in there. I know the House expects it to be in there. Certainly AUL and allied groups are expecting it to be in there. This is part of why we elected these representatives and these senators.”
A group of conservative Republicans has tried for years to strip Planned Parenthood of its federal funding. In fact, Pence was one of the first Republicans to raise the issue a decade ago, but he had few supporters then. But the effort gained traction two years ago with the release of videos by an anti-abortion group, accusing Planned Parenthood of selling fetal tissue, which the group strongly denies.
“A couple of years ago, I wouldn’t have said” the bill needs to include defunding, said Sen. Chuck Grassley (R-Iowa). Since the videos came out, “that kind of make it an easy answer.”