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The real fight over Planned Parenthood is not in Congress

It has been the month of Planned Parenthood in Congress. Fury against and ardent defense of the organization rose following the release of undercover videos showing Planned Parenthood officials discussing the procurement of fetal organs for research. That sparked intense House and Senate standoffs over the organization’s funding, with the chambers seeming to narrowly avert a potential government shutdown over the issue (for now). Hearings and investigations continue.

With so much attention focused on the fight on Capitol Hill, Americans may be missing a crucial point — a number of the changes Republican lawmakers are working hard to pass at the federal level have already been enacted by governors and state legislatures outside of Washington.

“What’s often been the case on the federal level is that we have divided governments,” said Drew Halfmann, an associate professor at the University of California, Davis, who studies the politics of health care. “That means there is a lot more gridlock at the federal level. That’s true for some states, but in many states you have uniform control of the government, and that really speeds things up and makes a lot more possible.”

Since the federal debate began, the governors of Alabama, Arkansas and Louisiana have all terminated Planned Parenthood’s Medicaid contracts, so that the organization could no longer be reimbursed for any Medicaid services it provides. Planned Parenthood is challenging the actions in court.

Already, in Arkansas, a federal judge temporarily reinstated Arkansas’ Medicaid contract with Planned Parenthood. On Tuesday a judge in Utah temporarily blocked an order by the state’s governor that cut off federal money to the group.

While more judges are expected to follow suit, the action is extremely concerning for the organization, which would have to radically rethink its funding plans if medicaid reimbursements were cut. Planned Parenthood says that cuts in funding can lead to closures, which would have a significant effect on its ability to provide health care. Currently Planned Parenthood clinics serve 2.7 million women and men.

Defunding Planned Parenthood at the state level is not a new phenomenon. Republican presidential candidates Chris Christie and Jeb Bush have campaigned on Planned Parenthood legislation they acted on as governors of New Jersey and Florida respectively.

“I’ve vetoed funding for Planned Parenthood and if I were president of the United States I would do exactly the same,” Christie said during a South Carolina town hall meeting in July. Since 2010, Christie vetoed family planning grant funds to Planned Parenthood four times in the state budget.

During the first Republican debate, Bush said the following about his legislative record on Planned Parenthood: “As governor of Florida, I defunded Planned Parenthood. I created a culture of life in our state.” In 2001, Bush vetoed two items in the state budget that funded Planned Parenthood. Planned Parenthood in Florida confirmed that since that time the organization has not received any state funding. One of the local affiliates said prior to the cuts, state assitance made up about a quarter of their budget.

Though these changes often fly under the national radar, they have profound implications. Due to funding cuts, Planned Parenthood New Jersey was forced to close two of its clinics in the span of one year. In Florida, they’ve had to make up for the state funding cuts with private assistance and grants. In the year following Texas’ slashing of the state’s Planned Parenthood budget, the organization closed 12 clinics35 remain.

“These attacks aren’t about Planned Parenthood,” said Dawn Laguens, executive vice president of the Planned Parenthood Federation of America. “They’re about the women who rely on us for birth control, cancer screenings, and other lifesaving and life changing care.”

For anti-abortion activists, however, the changes are signs of progress.

“To see this going forward on all levels is very encouraging,” Mallory Quigley, communications director of the pro-life Susan B. Anthony List said. “It also reflects that there is action to be taken on all levels of this fight. Planned Parenthood has been very good at securing every possible stream of tax payer funding from all levels, which means there is a lot of opportunities for the state and federal government to take action.”

So, while federal budget legislation to defund Planned Parenthood has been resolved on Capitol Hill until December, the states are still an open battlefield, and probably will be for a very long time.

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