Republican spending bill could deal a huge blow to abortion access in California

San Francisco Chronicle​

4 hours ago

Access to abortion in California could be substantially reduced if the House passes President Donald Trump's budget bill.
The legislation, now awaiting a final vote in the House, would eliminate federal Medicaid funding for any type of medical care to organizations that perform abortions.
An earlier version of the bill would have cut the funds off for 10 years, but lawmakers supporting the measure limited it to the 2025-26 fiscal year before the latest vote. Even so, Planned Parenthood, the nation's largest abortion provider, says it may have to close about one-third of its 600 U.S. clinics if it lost all $700 million of the federal funds it receives annually from Medicaid and the Title X family-planning program.
Planned Parenthood says its 115 clinics in California serve about one-third of its patients nationwide — nearly 1 million per year, about 80% of whom are low-income patients on Medi-Cal. Clinics that remain open, for Planned Parenthood and other abortion providers, might have to limit their services without increased funding from private donors or from state and local governments.
That means cancers would go undetected, sexually transmitted infections would be untreated and birth control would be less available. 'The public health infrastructure of California's most vulnerable communities will break down,' said Jodi Hicks, president of Planned Parenthood Affiliates of California.
Shelby McMichael, a Planned Parenthood spokesperson, said Wednesday that the organization 'worked with the state to ensure that these reproductive health services were in the state budget' for 2025-26, which includes funding for the clinics.
But McMichael told the Chronicle that the federal legislation was 'effectively a back-door abortion ban, even in a state like California where voters have affirmed that it's a constitutional right.' She was referring to a ballot measure approved by two-thirds of the state's voters in November 2022, five months after the Supreme Court repealed the nationwide constitutional right to abortion that it had declared in 1973.
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said the congressional action was 'a major step toward ending the forced taxpayer funding of the Big Abortion industry — a crucial victory in the fight against abortion, America's leading cause of death.'
Congress cut off federal abortion funding for low-income women in the Medicaid program with the Hyde Amendment in 1977. A 1981 California Supreme Court decision has enabled the state to replace the federal dollars with its own funds for Medi-Cal abortions.
California's laws would not be changed by the cutoff of federal funding to abortion providers. But by forcing shutdowns of abortion clinics and reductions in services from those that remain open, the congressional legislation would make it harder for many Californians to find abortion providers.
'Medi-Cal patients will have less places to turn for care, for any type of reproductive health care services, including abortion,' said Melissa Goodman, executive director of the Center on Reproductive Health, Law and Policy at UCLA Law School. 'The federal effort to defund those who provide abortion services is a key tactic for restricting abortion access in states that protect abortion by radically shrinking the pool of abortion providers who can afford to continue operating.'
Mary Ziegler, a UC Davis law professor and author of several books on reproductive law, said some health care providers in California may have to stop providing abortions because of the loss of funding. Or, she said, they 'may have to scale back other services, their wait times may get longer or they may close.'
In a separate action in March, the Trump administration ordered withdrawal of federal funding to California and other states for Title X, which pays for family planning programs for low-income residents and those who lack insurance. Those programs would have had to close without state funding, which was provided in the newly enacted 2025-26 budget.
But on Wednesday, Essential Access Health, a nonprofit that administers Title X grants in California, said it had been notified by the Trump administration's Department of Health and Human Services that the state would receive $12.2 million in Title X funding this year, about $1 million less than last year's family-planning funds. McMichael, of Planned Parenthood, said the state budget also includes funding to make up for the federal reduction.
'We recognize that this may be only a temporary reprieve,' as the administration could change course again in the coming months, said Shannon Olivieri Hovis, a spokesperson for Essential Access Health.
She said advocates of the funding have sued the Trump administration in federal court in Washington, D.C. over nationwide reductions in Title X funding. Federal courts blocked a similar action by Trump's first administration in 2019.
The congressional budget vote comes in the wake of the latest legal victory for abortion opponents, a Supreme Court decision allowing South Carolina to eliminate all Medicaid funding to Planned Parenthood or any other health care provider that also performs abortions. The state had banned the funding in 2018, saying funds provided for other services could be diverted by the providers to pay for abortions.
A federal appeals court said the cutoff violated a 1965 federal law that requires states to allow Medicaid patients to receive services at any qualified institution. But in a 6-3 ruling in Medina v. Planned Parenthood on June 26, Supreme Court Justice Neil Gorsuch said the law could be enforced only by the federal government, not by private parties like Planned Parenthood or the patient who joined the suit.
Although the ruling applied only to states with laws against abortion funding, it could also affect states like California, which has provided abortions and other reproductive care for women who have been denied treatment in their home state.