In Response to Davis and Gupta: Why Funding Planned Parenthood is Deceptive, Inappropriate, and Should End

Yuval Levin

I write in response to Anne Davis, MD, MPH and Pratima Gupta, MD, MPH, “Attacks on Planned Parenthood are Ideologically Driven and Dangerous,” Harvard Health Policy Review (Nov. 2015), available here.

Drs. Davis and Gupta are admirably frank in asserting the propositions they defend: They believe that abortion is an integral element of “comprehensive reproductive health care.” And they believe that taxpayer funding of Planned Parenthood is helpful to the practice of abortion in America, and therefore “defunding” it would be relatively harmful.

If every champion of taxpayer funding for Planned Parenthood were so clear and honest, the debate about such funding would be much improved. It would also lead to the end of such funding, as it plainly should.

The idea that taxpayer funding should advance the practice of abortion in America has been consistently rejected by congressional majorities for four decades. The so-called “Hyde Amendment,” first adopted in 1976 and reaffirmed every year since (under congresses led by both parties), prohibits funds appropriated to the Department of Health and Human Services from supporting the practice of abortion (except in cases of rape, incest, or a danger to the life of the mother).¹ Similarly worded prohibitions impose the same restriction on other federal funding streams. It is important to understand how limited their language really is: They do not prohibit or restrict elective abortion, but merely say the federal government will not actively support its provision with taxpayer funds. This constitutes a recognition of the intense debate about the legitimacy and morality of abortion, and commits the government to refrain from compelling Americans who oppose abortion to actively support it with their tax dollars.

Planned Parenthood is by far the nation’s largest abortion provider, ending the lives of more than 300,000 unborn children each year.² And yet, the abortion giant counts on federal taxpayers for more than a third of its annual revenue, according to the Congressional Budget Office.³ This obviously violates the spirit and purpose of the Hyde Amendment, and compels the American taxpayer into supporting the abortion industry.

Planned Parenthood is able to receive federal Title X family-planning funding and Medicaid funding because it maintains that these dollars do not support abortion, but only fund assorted contraceptive and other services the organization also provides. But money is fungible, and the scale of support involved is enormous. Providing $450 million in taxpayer funds to the titan of the abortion industry each year could hardly help but support its practice of abortion.⁴

Moreover, Planned Parenthood routinely co-locates its abortion and non-abortion services in the same facilities and provides direct referrals and counseling for abortion in its federally-supported clinics. This means that, even apart from other concerns about Planned Parenthood (including the organization’s documented failures to report criminal child abuse and failures to comply with state parental-notification laws),⁵ and the deeply disturbing practices and attitudes laid bare by a recent series of under-cover videos,⁶ the Hyde Amendment and related funding restrictions as written would already permit the administration to deny funding to Planned Parenthood. The Supreme Court affirmed as much in Rust v. Sullivan in 1991.⁷ At least one Republican candidate for president has already asserted that, were he elected next year, he would enforce the law accordingly.⁸ Others likely would, too.

Since the Obama administration has chosen to refrain from doing so, some in Congress would now like to clarify the law to make it perfectly plain that funding for Planned Parenthood in fact constitutes unacceptable material support for abortion and must end, and that the funds now directed to that organization should instead support the kinds of family-planning services (including contraceptive services) envisioned by Title X and provided by organizations that do not also engage in elective abortion.

Drs. Davis and Gupta suggest that such organizations (which vastly outnumber Planned Parenthood clinics)⁹ would not be able to step in and provide such services. They therefore argue that the provision of family planning services—and, they imply, even more general obstetric and gynecological services—should be held hostage to the practice of abortion in America. Rather than allowing the range of specialized providers to expand to meet the needs for which Title X funds are appropriated, they would have those dollars continue to provide backdoor funding to abortion.

To their credit, Drs. Davis and Gupta have too much integrity to sustain the pretense that these funds would not in fact reinforce the practice of abortion. Right after noting the claim that Planned Parenthood merely “also provides abortion with their non-federal funding stream,” they write, “And more to the point: Regardless of one’s personal feelings about it, abortion remains critical to women’s health and well-being.”¹⁰

This, of course, is where the disagreement really lies. Funding Planned Parenthood means supporting abortion. Federal law has stood opposed to providing such support with public money for four decades, and it is time to end the patent fictions that have enabled in practice the very opposite of what the law demands.

And more to the point: Regardless of one’s “personal feelings” about it, every abortion ends the life of an innocent human being. Elective abortion is a grave, avoidable injustice. Its scope and scale in our society is a stain upon the nation’s moral character. We should work to persuade our fellow citizens to see the inhumanity of abortion and defend basic human rights by ending that brutal practice. And at the very least, we must not compel those who already see the truth to nonetheless support abortion with their tax dollars.

About the Author

Yuval Levin, PhD is a fellow at the Ethics and Public Policy Center and the editor of National Affairs.

References

1. The text of the most recent version of the Hyde Amendment can be found, for instance, at https://www.congress.gov/113/plaws/publ76/PLAW-113publ76.pdf, p. 245.
2. Planned Parenthood, 2013-14 Annual Report, http://issuu.com/actionfund/docs/annual_report_final_proof_12.16.14_/0 (accessed 26 November 2015).
3. Congressional Budget Office. “Cost Estimate: H.R. 3134 Defund Planned Parenthood Act of 2015.” Washington, DC: Congressional Budget Office, https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/costestimate/hr3134.pdf (accessed 26 November 2015).
4. Ibid.
5. Americans United for Life, The Case for Investigating Planned Parenthood. Washington, DC: Americans United for Life, http://www.aul.org/wp-content/uploads/2011/06/PPReport_MAIN-REPORT_Download.pdf (accessed 26 November 2015).
6. See http://www.centerformedicalprogress.org/cmp/investigative-footage/
7. Rust v. Sullivan (89-1391), 500 U.S. 173 (1991), available at https://www.law.cornell.edu/supct/html/89-1391.ZS.html.
8. See Jeb Bush’s proposal to do so at https://jeb2016.com/backgrounder-health-care-plan/?lang=en (accessed 26 November 2015).
9. For a list of Federally Qualified Health Centers, see https://www.nachc.com/client/2013%20Key%20facts%20by%20state%20data.pdf
10. They offer no evidence to support the proposition that abortion is critical to women’s health and well-being. Trends in women’s health indicators (including even maternal mortality) do not suggest a significant change when abortion was legalized nationally in 1973. Assessments of women’s health indicators compared to men’s between Ireland, which has the tightest abortion restrictions among comparable nations, and other developed nations, including the United States (which has the most liberal abortion regime in the developed world), do not support the view that access to abortion is an important determinant of general health outcomes. See for instance, http://www3.weforum.org/docs/WEF_GenderGap_Report_2012.pdf. Most published arguments in support of Drs. Davis and Gupta’s position on this point treat abortion itself as a form of health care, and therefore treat their premise as a conclusion.