Recently renewed efforts by Congress and state policymakers to cut off public funding from many safety-net family planning providers, particularly Planned Parenthood, may foreshadow a continued onslaught of restrictions in 2017 and beyond. Alarmingly, while the Obama administration has served as a bulwark against many such attacks, the Trump administration may well enable them, warns a new analysis in the Guttmacher Policy Review.

The publicly supported U.S. family planning effort comprises thousands of safety-net health centers that offer high-quality, affordable contraceptive care to millions of women, particularly those who are young, low-income or otherwise disadvantaged. In order to stay open and serving their communities, these health centers rely on various public funding streams, including the Title X national family planning program, Medicaid, and other federal and state funds.

"Never in its history has the nation’s family planning safety net faced as significant a threat as it does today," says Kinsey Hasstedt, author of the new analysis. "The Obama administration has stopped Congressional and many state-level attacks. But the incoming administration is openly hostile to reproductive rights and unlikely to stop the relentless campaign by Congress and many state governments to defund Planned Parenthood, in particular—putting the health and wellbeing of women nationwide at risk."

Hasstedt details how recent efforts to restrict public family planning funding—usually under the guise of undermining abortion—have unfolded across the country. Since July 2015, 24 states have tried, and 15 have succeeded, in adopting some kind of funding restriction; many of these attempts have been stopped from going into effect by the courts. Hasstedt also discusses how states have sought to undercut their family planning safety nets through restricting different types of providers and funding streams, using various policy levers.

The analysis notes the far-reaching impact of having a hostile presidential administration, in addition to an already hostile Congress and many state governments. For example, it is now more likely that harmful legislation will be enacted at the federal level, such as a measure (vetoed by President Obama in January) that would have made Planned Parenthood ineligible to receive federal funding. The Trump administration may also support weakening or removing federal provisions that protect the integrity of the family planning safety net, such as new regulations from the Obama administration to stop states from directing Title X funds away from providers associated with abortion care.

"At stake is the health of those who rely on the nation’s publicly funded family planning programs and providers to obtain the care they need, particularly those who may find themselves without health coverage or who are low-income, young or otherwise underserved," says Hasstedt. "The potential harm to these individuals and their families—and to society as a whole—is considerable, especially at a time when the need for these services is increasing. Policymakers at all levels should be building up this critical safety net, not trying to tear it apart."

Full article: "Recent Funding Restrictions on the U.S. Family Planning Safety Net May Foreshadow What Is to Come," by Kinsey Hasstedt