Trump's efforts to defund Planned Parenthood threatens US healthcare system, study suggests

The Guardian

a day ago

Planned Parenthood clinics treated people who rely on Medicaid at more than 1.5m visits in 2024, new research published Wednesday shows. But the reproductive health giant's ability to treat those patients is now in jeopardy due to Republicans' efforts to 'defund' Planned Parenthood by kicking it out of Medicaid.
Donald Trump's tax and spending package, passed in July, bans Planned Parenthood from receiving reimbursements from Medicaid, the US government's insurance program for low-income people. After Planned Parenthood sued over the ban, a judge temporarily stopped it from taking effect.
If the ban moves forward, experts warn that it could cripple the entirety of the US healthcare social safety net.
'Planned Parenthood has filled a very important role in the reproductive healthcare safety net for people living on low incomes,' said Kari White, executive and scientific director at Resound Research for Reproductive Health. White was the lead author on the research paper released Wednesday. 'Other providers have counted on them to do so. They just don't have the capacity to step in and fill the place that Planned Parenthood has had in the safety net.'
In particular, White said, people will probably struggle to access contraception. After Texas started to ice Planned Parenthood out of its Medicaid program more than a decade ago, placements of contraceptive implants and IUDs – two of the most effective methods of birth control – fell by more than a third in counties that had a Planned Parenthood clinic. That indicated that those who had used Medicaid to obtain contraception at Planned Parenthood were no longer doing so. Provision of injectable contraceptives also fell; among people who used it, births covered by Medicaid rose by almost a third.
Republicans have long sought to defund Planned Parenthood over the organization's commitment to providing abortions. But Planned Parenthood does not rely on Medicaid to fund its abortion provision as it is already illegal to use federal dollars, including Medicaid, to pay for the vast majority of abortions. The 1.5m visits documented in Wednesday's research paper, which was published in the medical journal Jama, only include visits for reasons other than abortion.
More than 80 million people in the US use Medicaid, and 11% of female Medicaid beneficiaries who are between the ages of 15 and 49 and who receive family-planning services go to Planned Parenthood, according to an analysis by the non-profit KFF, which tracks healthcare policy. But defunding Planned Parenthood will probably hit blue states hardest, since they are home to larger numbers of Medicaid beneficiaries.
About 50% of the people who visit Planned Parenthood of Orange and San Bernardino Counties, which operates clinics in California, use Medicaid in some way, experts told the Guardian. If the defunding moves forward, the affiliate would lose roughly $50m, or half of its budget. It already went without Medicaid reimbursements for about five weeks earlier this year.
'It was a really stressful time for my staff. They have fees and bills to pay. And some of them probably were wondering if they would still have a job,' recalled Dr Janet Jacobson, the affiliate's medical director and vice-president of clinical services.
'It's hard not to take federal legislation that basically comes out and names you and threatens you and tries to defund you personally.'
Jacobson is particularly worried about the future of a program at Planned Parenthood of Orange and San Bernardino Counties that screens about 100,000 patients annually for sexually transmitted infections.
Between July 2024 and June 2025, the affiliate uncovered more than 1,500 positive tests for syphilis, as well as almost 400 cases of trichomoniasis in pregnant women. Both STIs – which often do not have symptoms in their early stages – can have devastating consequences for pregnant women and their babies, such as preterm birth and birth defects.
'They haven't been able to ban abortion outright, so they're trying to take away the money for services like cancer screening, STI testing, birth control, and essentially trying to shut us down that way so that we can't provide abortion,' said Nichole Ramirez, senior vice-president of communication and donor relations at Planned Parenthood of Orange and San Bernardino Counties.
'They're taking away this vital care from mostly underserved communities. They're willing to have an increase in STIs, have a potential increase in cancer rates so that they can try to get rid of abortion.'