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Planned Parenthood Is Just The Beginning

The fight over family planning will be at the heart of Congress's coming budget battle

Olivier Douliery/Getty Images

Since videos emerged last month showing Planned Parenthood staff discussing how they provide fetal tissue and organs to researchers, Republicans have been falling all over themselves to insist that the organization be defunded. But the GOP’s defunding campaign isn't actually about stopping fetal tissue research. It's about defunding family planning services that have nothing to do with abortion, in the hopes of derailing the groups that provide them. And it's tied to a far bigger spending fight that awaits Congress when it returns from its August recess.

Republicans today have more leverage to push for cuts of all kinds, thanks to the deficit reduction deal that President Barack Obama struck with congressional Republicans in 2011. The bipartisan Budget Control Act cut $900 billion in spending immediately, then included $1.2 trillion in automatic cuts over the next decade—spending cuts designed to be so blunt and dumb that Congress would be forced to come up with an alternative way to reduce the deficit. But Congress never did come up with a replacement for sequestration. Republicans refused to increase taxes, and Democrats refused to touch entitlements until they did so, resulting in political deadlock.

So sequestration took effect in 2013, making across-the-board cuts to a huge array of domestic and defense programs—essentially, anything that requires yearly appropriations from Congress. That includes the Title X funds that are a central part of the GOP's defunding campaign against Planned Parenthood. The organization is one of the biggest recipients of Title X funds for family planning, which covers STD testing, contraception, and cancer screenings, but which, by law, doesn’t pay for abortion. Congress had already begun to pare back funding for Title X since 2010. Under sequestration, Title X funds were cut even further, by $16 million in 2013.

In late 2013, Congress finally passed a bipartisan deal, hammered out Senator Patty Murray and Representative Paul Ryan, to blunt the worst of sequestration. The two-year deal reversed about one-third of the total cuts. Title X funding, for example, got an $8 million bump in 2014. But that's still the lowest level of funding for Title X since 2005. And the Ryan-Murray deal expires at the end of the year, at which point sequestration kicks right back in. So the same austerity measures—the ones by design meant to be blunt and dumb—are on the horizon again. And they threaten to choke off funds not just to Planned Parenthood, but a huge array of programs across the entire government.

Family planning advocates blame austerity—not anti-abortion ideology—for driving the cuts to the program. “Over the past five years, Title X, similar to most federal discretionary funding programs, has sustained significant cuts as a result of tremendous pressure to reduce the federal deficit,” says the National Family Planning and Reproductive Health Association. The group points out that legislators have cut Title X funds by $39.2 million—a total reduction of more than 12 percent—since 2010. That’s forced family planning clinics to cut back staff and hours; Republicans ultimately hope that it will force Planned Parenthood clinics to close. (The Senate’s latest failed attempt to defund Planned Parenthood would block both Title X and Medicaid funds to the group; the measure indicates that money will be “made available to other eligible entities to provide women's health care services,” but it’s unlikely that other family planning centers will be able to fill the gap, particularly in rural and other underserved areas.)

Congress needs to pass a budget by September 30 in order to keep the government funded—though legislators may pass a short-term funding measure to keep things going until the end of the year. Already, Republicans have made it clear that they're more than happy to accept austerity when it comes to anything other than the military. "We must abide by those numbers we agreed upon in the Budget Control Act,” Representative Diane Black told the Wall Street Journal in March.

For 2016, the spending caps under sequestration are roughly equivalent to 2015 spending levels—$521 billion for defense discretionary spending and $492 billion for non-defense spending. But that doesn't just mean a continuation of the status quo. The budget caps mean that any increase in funding in one area has to be offset by cuts in another. And the same funding won’t go as far in 2016. There are certain areas that will eat up more of the pie: The cost of veterans’ health care has been rising; federal employees everywhere are expected to get a 1.3 percent pay increase; and inflation, while low, will also reduce purchasing power.

Sequestration will mean that those dollars have to be stretched further. Federal agencies that have found ways to cope with the spending cuts warn that they’re already reaching the breaking point. On the defense side, for instead, “a decent amount of the savings came from deferring things—training troops, repairing equipment,” said Marc Goldwein, senior vice-president for the Committee for a Responsible Federal Budget. “You can only play that game a few times.”

Congressional Republicans have already detailed the cuts they want to enact, and have placed family planning squarely in the crosshairs. Weeks before the first Planned Parenthood video emerged, Senate Republicans proposed to cut Title X by $30 million more in 2016. House Republicans have already passed an appropriations bill that would zero out Title X funding entirely. But it’s not just family planning that’s at stake. The same House bill also cuts funding for Obamacare, and eliminates workforce training and pre-K programs. Other spending bills cut everything from infrastructure repair and legal aid to lead-poisoning prevention.

Republicans don’t need anti-abortion ideology to justify such cuts; they have the rhetoric of fiscal responsibility to back them up. “The bill reflects careful consideration of every program, cutting the fat and making the most of every dollar,” said House Appropriations Chair Hal Rogers of the bill that would eliminate Title X funding. “This is a fiscally responsible bill that reduces discretionary spending by nearly $4 billion.” And the constraints of sequestration have made it that much easier for Republicans to argue for funding reductions of all kinds. Under the spending caps, if Republicans do want more money for certain things (Alzheimer’s research, pandemic disease stockpiles), they necessarily have to reduce money for others (Planned Parenthood, Amtrak).  

So while Republicans have threatened to shut down the government over Planned Parenthood, that funding is just one tiny piece of the broader fight facing Congress this fall over whether, and how, to undo sequestration once again. President Obama has already proposed lifting the defense and non-defense spending caps by $37 billion each, urging the end of sequestration that "doesn’t differentiate between smart government spending and dumb government spending."

Democrats are hoping that sequestration's impact on defense spending will force Republicans to deal. The House GOP tried to get around the defense caps by simply turning the Overseas Contingency Operation fund—originally used to pay for the wars in Iraq and Afghanistan—into a slush fund, as it isn’t subject to sequestration. That move, however, already faces a veto threat from Obama, and Democrats insist that any increase in defense spending has to be matched by an increase in non-defense spending.

The reality is that discretionary spending is a terribly ineffective way to cut the deficit, which is already at a seven-year low. But because of the 2011 deficit deal, the only way to raise either of those spending caps is to offset them with cuts or revenue elsewhere. And that’s become increasingly difficult as Republicans still refuse to raise taxes, and Democrats refuse to cut entitlements—the real driver of government spending—until they do.

The gridlock has prompted Congress to resort to increasingly questionable means of funding essential government functions. To fund the highway bill, for instance, Senate Republicans have proposed selling crude oil from the Strategic Petroleum Reserve and blocking Social Security payments to those who have felony warrants. For the moment, it’s completely unclear how Congress would come up with the money for yet another priority—replacing sequestration. “They’re looking for nickels and dimes off the pavement,” said Stan Collender of Quorvis Communications, a former Democratic budget aide.

Republicans didn't need undercover videos to choke off funding to Planned Parenthood. The bipartisan insistence on austerity has already squeezed funding for family planning, along with programs across the entire government. The question really isn't whether sequestration will take place, but how much. And family planning simply tops the GOP's list of what to cut.