The victims of this [throwaway] culture are precisely the weakest and most fragile human beings — the unborn, the poorest, the sick and elderly, the seriously handicapped, etc. — who are in danger of being ‘thrown away,’ expelled from a system that must be efficient at all costs…It is necessary to raise awareness and form the lay faithful, in whatever state, especially those engaged in the field of politics, so that they may think in accord with the Gospel and the social doctrine of the church and act consistently by dialoguing and collaborating with those who, in sincerity and intellectual honesty, share — if not the faith — at least a similar vision of mankind and society and its ethical consequences. Pope Francis, Speech to a delegation from the Dignitatis Humanae Institute, Dec. 7, 2013
As the debate over abortion has intensified in recent years, much of the focus of the discussion has centered on Planned Parenthood, the United States' largest abortion provider. In 2014-2015 (the last year for which data is available), Planned Parenthood affiliates performed 323,999 abortions.
In 2015, undercover videos released by the Center for Medical Progress raised concerns about the allegedly illicit sale of fetal body parts and tissue and renewed the ongoing debate about taxpayer funding for the organization. This series will examine public funding for Planned Parenthood (at the federal, state, and local levels), as well as other "special" legislative treatment Planned Parenthood has received here in California.
Federal Funding of Planned Parenthood
Planned Parenthood bills itself as a "non-profit" provider of "women's healthcare services." However, the data reveals that Planned Parenthood is heavily subsidized by the federal government.
In the fiscal year ending June 30, 2015, Planned Parenthood reported revenue of $1.4 billion and a net revenue of $149.5 over its expenses. A large proportion of that funding comes from taxpayers. Approximately $553.7 million (or 43% of Planned Parenthood's total revenue) comes from taxpayer dollars.
According to Planned Parenthood, total revenues, net income after expenses, the amount of taxpayer funding, and the percentage of its income coming from taxpayer all increased over the prior year, while the number of clients served decreased.
These figures have resulted in increased scrutiny at the federal level. In 2013, several pro-life members of Congress requested that the nonpartisan Government Accountability Office (GAO) conduct an audit of taxpayer funding of abortion services at six organizations - Planned Parenthood, Population Council, International Planned Parenthood Federation of America, Guttmacher Institute, Advocates for Youth and Sexuality Information, and the Education Council of the United States.
According to the report, Planned Parenthood and its affiliates received $344.5 million in federal funds and another $1.2 billion in funding from Medicaid (which includes a combination of federal and state funds) for a total of $1.5 billion over three years from all federal programs. The organization receives $1.2 billion from Medicaid, $201 million from the Title X family planning program $40.6 million from Title XX Social Services block grants and $25.9 million from the Title V Maternal and Child Health Services block grant.
What is the "Hyde Amendment?"
Most Americans have heard something about "the Hyde Amendment." First passed in 1976, this amendment excludes abortion from Medicaid, the federal program that provides health care services to low-income individuals. However, the Hyde Amendment is not a complete ban, as Congress has enacted several exceptions over the years. Currently, the federal Medicaid program requires funding of abortions in cases of rape or incest, as well as when the mother's life is endangered by a physical disorder, illness or injury.
A majority of states have followed the federal government in restricting public funds used for abortion. However, 17 states have policies that direct their Medicaid programs to pay for most “medically necessary” abortions. Four of these states do so voluntarily, and another 13 states do so pursuant to court decisions that have mandated nondiscriminatory public funding of abortion. This latter group includes California, which mandated such nondiscriminatory public funding in Committee to Defend Reprod. Rights v. Myers, 625 P.2d 779 (1981).
While the Hyde Amendment is an important federal policy concerning the use of taxpayer dollars to fund abortion, one should be cautious not to overstate the impact of this policy on the ability of abortion providers such as Planned Parenthood to provide abortions. Federal funding restrictions such as the Hyde Amendment may technically prohibit the use of taxpayer funds for abortion, but in practice they are fungible funds that simply enable abortion providers to spend a greater share of their private donations on abortion.
Indeed, the significance of these fungible federal funds was recently highlighted by the Obama administration’s issuance of a rule on December 16, 2016, that prohibits states from denying federal Title X family-planning funds to Planned Parenthood and other abortion providers. The new rule goes into effect on January 18, 2017, two days before President-elect Trump is inaugurated.
Planned Parenthood's "3%" Argument
Planned Parenthood and its defenders have argued that it is not objectionable to provide public funding to the organization since abortion services represent only a small portion of their total activities. They routinely cite the statistic that abortion comprises only three percent of their activities.
However, many commentators have challenged this "3%" statistic as misleading. First, this statistic in based on "unbundling" abortion services into discreet tasks and counting them separately. As a National Review editor stated in an editorial, "The sponsors of the New York City Marathon could count each small cup of water they hand out (some 2 million cups, compared with 45,000 runners) and say they are mainly in the hydration business."
Second, Planned Parenthood does not specify what share of this figure is represented by contraceptives (but they do state that contraceptives represent one third of their services). Many contraceptives, including the Plan B pill and intrauterine devices are abortifacient in nature and should be included in the definition of abortion services. Including such contraceptives would dramatically increase this figure.
In 2013, Rachel Larimore, senior editor of Slate Magazine, stated that the 3% figure was the "most meaningless abortion statistic ever":
"[I]t’s easy to calculate, as the Weekly Standard did, that Planned Parenthood gets at least a third of its clinic income—and more than 10 percent of all its revenue, government funding included—from its abortion procedures.
“Ask anyone who runs a for-profit business or nonprofit charity if something that brings in one-third of their revenue is “central” to their endeavor, and the answer is likely to be yes. So yes, abortion is central to what Planned Parenthood does."
What Does the Future Hold for Planned Parenthood Under the New Administration and Republican-Controlled Congress?
In light of the recent presidential election, it is fair to ask how public funding for Planned Parenthood would fare under a Republican administration and Republican-controlled Congress. Historically, the Republican Party’s platform has been pro-life. In fact, at the Republican National Convention last July, the party adopted its strongest pro-life platform yet. It is, however, still difficult to predict the future of Planned Parenthood’s public funding, but we can look to recent comments made by the President-elect for additional insight.
In March, many pro-life advocates were troubled by remarks made by Mr. Trump that appeared to praise Planned Parenthood. At a news conference at the time, Mr. Trump stated, “Look, Planned Parenthood has done very good work for many, many — for millions of women. And I’ll say it, and I know a lot of the so-called conservatives, they say that’s really … cause I’m a conservative, but I’m a common-sense conservative.” Mr. Trump indicated that he would not fund Planned Parenthood “as long as you have the abortion going on,” but noted the “millions of people — and I’ve had thousands of letters from women — that have been helped.”
However, in a letter released in September, Mr. Trump stated that he would defund Planned Parenthood "as long as they continue to perform abortions, and reallocat[e] their funding to community health centers that provide comprehensive health care for women." In the same letter, Mr. Trump committed to (1) nominating pro-life justices to the United States Supreme Court, (2) signing into law the Pain-Capable Unborn Child Protection Act, which would end painful late-term abortions nationwide, and (3) making the Hyde Amendment permanent law to protect taxpayers from having to pay for abortions.
And in an interview on "60 Minutes" following his election, Mr. Trump stated that his role in appointing Supreme Court justices is "very important" and that he plans to appoint pro-life justices. “I’m pro-life,” he said. “The judges will be pro-life.”
Moreover, Vice President–elect Mike Pence is a longtime pro-life advocate. As Governor of Indiana, he signed several abortion-restrictive measures into laws, even banning abortion in cases where the fetus has a “genetic abnormality,” and has fought to defund Planned Parenthood.
Recently, in an interview with Kaiser Health News in December 2016, Kathy Kneer, CEO and president of Planned Parenthood Affiliates of California, spoke about the potential federal funding impact under a Trump administration. “There are different pathways he [Trump] could take. He could issue an executive order his first day in office to restrict the Title X federal family planning program and eliminate any providers who also provide abortion.” With respect to the Medicaid program, Kneer notes that after a majority vote in both houses, the President-elect could then sign a bill denying Planned Parenthood eligibility to participate in the program.
Since it is still unknown how Planned Parenthood’s federal funding will be affected by the President-elect and Republican-controlled Senate and House of Representatives, pro-life advocates must remain diligent. House Speaker Paul Ryan (R-Wisconsin) has recently promised to include its defunding in the “repeal and replacement” of the Affordable Care Act. How or when that process will unfold is also unclear at this point.
 Planned Parenthood Federation of America, 2014-2015 Annual Report (Report), at https://www.plannedparenthood.org/files/2114/5089/0863/2014-2015_PPFA_Annual_Report_.pdf, p. 30.
 Report, pp. 32-33.
 Report, pp. 32-33.
 Planned Parenthood Federation of America, 2013-2014 Annual Report