Last Thursday, Vice President Mike Pence traveled to Capitol Hill to break a 50-50 tie in the Senate for Senate Joint Resolution 13, which expresses congressional disapproval of President Obama’s Health and Human Services (HHS) rule ensuring the best use of Title X funds. This resolution, which will now be sent to President Trump’s desk to roll back Title X protections put in place by the rule, threatens a funding pipeline for clinics that provide basic family planning and reproductive health care for millions of Americans nationwide.
Title X, through its Family Planning Program, allocates federal funds to states for distribution to health providers—such as Planned Parenthood—that provide basic health care and preventative family planning services. It was signed into law in 1970 by President Richard Nixon, with extensive bipartisan support. Indeed, President Nixon wrote to Congress in support of implementing Title X, saying: “It is my view that no American woman should be denied access to family planning assistance because of her economic condition.”
Nearly a half-century later, over 4,000 health clinics nationwide currently receive Title X funds and therefore must provide family planning and related preventive care to patients—regardless of income. These services are free for those living below the federal poverty level and adjusted on an income-based scale, otherwise. Notably, those without health insurance are also covered under Title X.
More than 4 million Americans depend on services funded by Title X, which include cervical and breast cancer screenings, birth control, and testing/treatment for sexually transmitted infections like HIV. According to Planned Parenthood, nearly 90 percent of those served by Title X have incomes that are below 250 percent of the federal poverty level. Especially for Americans living in rural areas, these clinics are often the only access points to basic primary and family planning health care. (Washington State and Indiana, among others, serve as compelling case studies illustrating this point.)
Attacks on Women’s Health via Title X
Recent years have witnessed an increase of attacks on women’s health providers like Planned Parenthood. One strategy states have attempted is withholding Title X funds from health clinics that also provide abortion or abortion referral services—despite the fact that the Hyde Amendment already prohibits federal funds from being used for most abortions. In response to these attacks, the Obama administration put forth an HHS rule which essentially prohibits states from excluding otherwise qualified providers due to their provision of unrelated services like abortions. The rule went into effect two days before Obama left office.
Cue House Joint Resolution 43, which was introduced just twelve days later to indicate congressional disapproval of the HHS rule. The resolution was passed by the House on February 16; S.J. Res. 13 is simply an identical version of this House resolution.
The advancement of S.J. Res. 13 comes at the heels of a March 29 Women’s Empowerment event at the White House commemorating Women’s History Month at which both the president and vice president spoke; as well as House Speaker Paul Ryan pulling his proposed American Health Care Act (AHCA) from Congress due to a vote shortage (which would have had detrimental effects on reproductive and women’s health).
The Split by Party and Gender in Congress on Title X Protections
Less than a week after the vice president tweeted a picture of himself (seen above) and only white, male colleagues negotiating to remove maternity care as an essential benefit in the AHCA, let’s take a look at the gender representation in the U.S. Congress below.
At 21 percent overall, women have slightly higher representation in the Senate than in the House (19 percent). In both cases, there is a higher number of women representatives belonging to the Democratic Party than the Republican.
When H.J. Res. 43 passed through House (230 for, 188 against, twelve no votes), all members voted according to party lines, with the exception of two Democratic men who voted in favor: Representative Collin Peterson (D-MN) and Representative Dan Lipinsiki (D-IL).
Six weeks later in the Senate vote on S.J. Res. 13—which required only a simple majority due to its categorization as a Congressional Review Act (CRA) bill—senators also voted primarily along partisan lines, with all Democrats and Independents voting against its passage, and nearly all Republicans voting for. However, Republican women Senator Susan Collins (R-ME) and Senator Lisa Murkowski (R-AK) voted against their overwhelmingly majority-male party in voting “no.” The two senators have both previously spoken out against efforts to choke organizations like Planned Parenthood.
The fact that the members who voted against the majority opinions of their parties on a resolution rolling back women’s health boiled down to men voting for the resolution and women voting against is significant.
Clearly, the dominance of partisan politics in the U.S. Congress cannot be discounted in our two-party system. However, the fact that the members who voted against the majority opinions of their parties on a resolution rolling back women’s health boiled down to men voting for the resolution and women voting against is significant—particularly when viewed in context of the low representation of women in Congress (and even lower within the Republican party). Though the sample size of women in American legislative bodies is both historically and currently too small to be sure, the reality that 40 percent of Republican women senators voted against their party and against this CRA is telling of the potential difference more women representatives (who globally are far more likely to support legislative initiatives advancing and protecting women’s health) would have made. Just a few more women senators might have led to a different outcome in last week’s vote.
It is worth recognizing that this identity analysis (which oddly enough, is a lens that white males, as the only group adequately represented in politics, tend to critique) only scrapes the surface with regard to representatives voting on issues that will not affect them personally, but have incredibly adverse effects for most Americans on the basis of not just gender, but also race, socioeconomic status, and health insurance.
Senator Sherrod Brown (D-OH) had some choice words on the matter on the Senate floor Thursday: “This is not about abortion. The federal government does not provide funding for abortion. Say that again with me: the federal government does not provide funding for abortion, period.” He continued, “This is mostly men in this body and in the body down the hall [in the House] who have health care paid for by the American public who are voting to take away health care mostly for women.”
Despite the gender representation disparity in both bodies of Congress and between the two major political parties, the vote was a tie amongst the one hundred senators—prompting the vice president’s presence. As Senator Mazie Hirono (D-HI) put it, “Mike Pence was here because Republicans couldn’t find enough men to tell women what to do with their bodies.”
Those men on the Republican party platform currently dominating representation in Congress have, by and large, anti-abortion stances. By failing to draw connections between programs like Title X that provide contraception with lower teen and unintended pregnancy as well as abortion rates, beyond inadequately representing and physically harming their constituencies (the majority of which, across genders and political parties, supports funding for women’s health providers like Planned Parenthood), they have created the ultimate paradox that begs two important questions. First, what is their end goal? The policy points of anti-abortion and anti-preventive care are contradictory, with a sole commonality of policing women’s bodies. Secondly, beyond working toward equal gender representation in government for the sake of democratic ideals, in light of an identity-based analysis of S.J. Res. 13, just how much literal representation of their gender do American women need in government for their health care to be safe?
Cover Photo: @VP Twitter account.