US Politics Special: Does Planned Parenthood Pay the Price for the Budget Deal?

Following up on this weekend's analysis of the last-minute deal on the Fiscal Year 2011 budget that averted the shutdown of the Federal Government....

As part of the deal, Democrats agreed to hold votes in the Senate on repealing the health care law and defunding Planned Parenthood. At first, this budget agreement appeared to be a victory for the Democratic position, holding the line against the level of cuts demanded by conservative members of the House of Representatives.

See also US Politics Analysis: A Late-Night Deal Averts A Government Shutdown

The outline of the eventual understanding emerged on Friday afternoon, when Politico reported two of the main advocates for a defunding of Planned Parenthood --- through a "Title X rider" --- were prepared to accede to Democratic demands and remove the immediate cut-off, with the understanding that the matter would be re-considered as a stand-alone matter separated from the deficit discussions.

Here is the context around the issue, as well as the Democratic claims that Republicans were prepared to shut the government down over their ideological commitment to, as Senate Majority Leader Harry Reid put it, “sacrifice the health of women" or, for House Minority Leader Nancy Pelosi, their "war on women".

In 1970, President Richard Nixon passed the Title X amendment to the 1944 Public Health Safety Act. This was designed to provide federal funds for organisations that distributed family planning advice and contraceptive services, giving priority by law to persons from low-income families. The conservative rationale for supporting Title X was that it would prevent the growth of welfare rolls as, at that point in time, the constitutional right for abortions had not yet been established.

However, after the Supreme Court decision in Roe v. Wade in 1973 established that right to abortion, Republicans argued federal funds were being used to provide terminations under the guise of family planning, and in 1976 the Hyde Amendment, according to Planned Parenthood's organisational history, "disenfranchised poor women" by prohibiting the use of Medicaid money for abortions.

After a few decades of more proposed anti-abortion restrictions --- some successfully blocked by Planned Parenthood's advocacy branch, some not --- the latest Republican attempt to prevent federal funds from financing abortion procedures came in February. The  Pence Amendment to H.R.1, the bill passed by the House calling for $61 billion in cuts in discretionary spending, This amendment stopped federal funds from going to Planned Parenthood.

Representative Mike Pence (R-Ind.), who proposed the amendment, stressed in a one-page flyer “would NOT reduce overall funds available for family planning under Title X". Their money would simply go to to other community organisations offering family planning advice who did not offer access to abortion procedures. Pence's contention is that Planned Parenthood does not use federal funds for abortions, but financing its educational and preventative services, the federal support frees up money received from individual and philanthropic donations to provide abortion procedures.

Planned Parenthood countered, in language that directly mirrors the phrases used by Democrats to oppose the Title X rider last week, that “the Pence proposal would cut off the approximately 1.4 million Medicaid patients served by Planned Parenthood from their source of healthcare", not their source of family planning advice. Planned Parenthood argues that, in many rural and poor urban areas, their doctors and nurses provide the only access to health care for low-income families.

The Pence Amendment, however, was not the sticking point in last week's last-minute discussions. In the face of resolute opposition to the amendment, Republicans changed it so Title X money would be awarded to states as a block grant, rather than going to individual organisations. It would then have been up to the states whether they funded their Planned Parenthood clinics . Although that option will still be on the table when the matter comes up before the Senate, the debate will likely return to the Pence Amendment's call to end all federal funding for Planned Parenthood.

So, a government shutdown has been avoided. The worrying aspect of the weekend's events, however, was that Congress came so close to abdicating one of its most important functions --- financing government spending --- over one or two issues that will prove ultimately irrelevant to America's long-term fiscal future. That is not to dismiss the importance of Planned Parenthood for millions of Americans, but to note that the stakes are only going to get higher when the debt limit and the Republican 2012 budget proposal become the major topics of debate in Washington.