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WASHINGTON - The emergent federal budget bogeyman is actually one of the most well-recognized health providers for women, and the sticking point for negotiations is one of their least sought-after services that the government doesn’t even pay for.
It's about abortion, an issue that divides Democrats and Republicans deeply, and has made Planned Parenthood a household name.
“If you want an abortion, you go to Planned Parenthood,” Republican Senate Whip Jon Kyl said on the Senate floor Thursday morning. “That’s well over 90 percent of what Planned Parenthood does.”
That’s not true.
The chain of women’s health centers is one of the few places that low-income and no-income women can seek out a legal abortion in the United States. But those abortions aren’t subsidized by the federal government -- and are only about 3 percent of the services they provide.
The other services are STD testing, contraception provision, cancer screening and other preventative health care procedures for women that the federal government has paid for since 1970. That pot of Title X services is a Nixon-era invention.
“It is my view that no American woman should be denied access to family planning assistance because of her economic condition,” then-President Richard Nixon said to Congress in 1969. “I believe, therefore, that we should establish as a national goal the provision of adequate family planning services ... to all those who want them but cannot afford them. This we have the capacity to do.”
But like all other federal funding, Title X funding can’t be used to fund abortions.
It hasn’t been legal to fund abortions with federal dollars since 1977, that being when the Hyde Amendment came into force.
“We do a very, very diligent job of keeping those services separate,” said Annette Magnus, a spokeswoman for Planned Parenthood in Nevada.
Planned Parenthood provides Title X services through its chief Las Vegas location at Flamingo and Pecos Boulevard, where last year, it served 6,000 people -- men and women. Men are eligible to receive STD testing and treatment at Planned Parenthood centers, too, even though they are primarily geared toward women’s health.
“Cutting these services doesn’t only hurt women, it’s going to end up hurting the economy, too,” Magnus said.
“Over 97 percent of the people we serve in Las Vegas are uninsured ... and since the economy started souring, we’ve seen an uptick in women coming back to us who used us in college," she continued. "They now need to come to us for PAP smears and breast exams because they don’t have anybody else to turn to.”
Republicans aren’t buying that argument.
“You don’t have to go to Planned Parenthood to get your cholesterol or blood pressure checked,” Kyl said.
They have a point. In 2006, Planned Parenthood received only about 11 percent of the Title X funding that’s available nationwide. The predominant share goes to funding local and community health centers and hospitals that provide the same services.
Those health centers aren’t bearing the full brunt of the Republicans’ rider-based push to strip federal funding, but they aren’t escaping unnoticed either.
The Republican budget includes a provision to convert federal Title X funds into block grants, leaving it up to states to decide where the dollars are distributed. That would effectively allow Republican governors to decide not to fund Planned Parenthood, or any other women’s health group that also provides abortions.
If the argument boils down to that provision, that would reconcile the political statements being made on either side. Senate Majority Leader Harry Reid says the Planned Parenthood rider is the "one issue remaining" while House Speaker John Boehner maintains that riders have been resolved, and that the continued disagreement is about spending.
If the Planned Parenthood issue is mired in the language of Title X health care cutbacks, they're not necessarily in disagreement about what the source of the disagreement is.
But regardless of the form in which it appears, Democrats are vehemently -- and very personally -- objecting to defining the value of women’s medicine generally by one very specific, legal service that institutions like Planned Parenthood offer alongside a predominantly uncontroversial portfolio of health services; and holding the whole country’s budget hostage to it as well.
“Republicans are asking me to sacrifice my wife’s health, my daughter’s health, and my nine granddaughters’ health,” Reid said. “I’m not going to be part of that. I won’t do it. As a legislator, I’m frustrated. As an American, I’m appalled. And as a husband, a father, and a grandfather, I’m personally offended.”
One solution may be what was floated by Senate Budget Chairman and Democrat Max Baucus. He's not in the room with the negotiators, but seemed pretty confident Friday afternoon that the way forward to resolving the budget before midnight was to hold a separate vote on de-funding Planned Parenthood, to clear the air in a manner like what Congress did earlier this week on the Environmental Protection Agency's climate change and greenhouse gas regulatory authority.
No changes to the EPA passed, but the EPA issue does appear to have been resolved as far as the budget negotiations go in the wake of those votes.
But there's a potential catch there: if Congress votes to specifically de-fund Planned Parenthood with a free-standing, into-perpetuity law, as opposed to under the umbrella of an annual, and thus eventually fungible budget, it might qualify as a bill of attainder -- which would make it unconstitutional even if it passes.
Bills of attainder are bills that punish specific institutions, and those are a no-go under the Constitution.