By Jessica F. Simmons
May 13, 2025
The budget package proposes steep health care cuts—and includes a new push to block patients from accessing reproductive care.
In a 30-24 party-line vote, cancer screenings, STI treatments, birth control, and other routine health care services are now one step closer to being cut off for millions of low-income Americans, after the US House passed a Republican-backed budget bill, Wednesday afternoon.
The bill is known as a reconciliation bill, a type of legislation Congress uses to fast-track major changes to federal spending and tax policy. Because of a special set of rules, reconciliation bills can pass the US Senate with a simple majority, bypassing the 60-vote threshold that typically blocks partisan legislation.
Republicans are using this process to advance a broad proposal that aims to extend President Trump’s 2017 tax cuts, which primarily benefited corporations and the wealthiest Americans, and make at least $1.5 trillion in cuts to key programs like Medicaid. Tucked inside the bill’s pages are major changes to how Medicaid operates—including a provision that would block Medicaid patients from receiving care at Planned Parenthood, the nation’s largest provider of reproductive health services.
“Defunding Planned Parenthood would be catastrophic to communities, put countless lives at risk, and wreak havoc on our public health system,” said Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America in a statement. “They’re set on depriving patients—particularly people who already have the hardest time getting health care—of access to affordable cancer screenings, birth control, STI testing and treatment, and many other essential reproductive health care services.”
Planned Parenthood is a national network of nonprofit clinics that provide reproductive and preventive health care. Most patients use Planned Parenthood for services like birth control, testing and treatment for sexually transmitted infections, breast and cervical cancer screenings, and annual wellness exams. The majority of Planned Parenthood patients are low-income and use Medicaid to pay for care.
The organization also provides abortion services at many of its centers, but federal Medicaid dollars are already not allowed to cover abortion care except in cases of rape, incest, or life endangerment—a restriction known as the Hyde Amendment.
What the bill would do
On Tuesday afternoon, the House Committee on Energy and Commerce began the formal process of marking up the reconciliation bill. Tensions flared almost immediately after the hearing began. Just as Republican Chairman Brett Guthrie finished his opening remarks, five demonstrators—three in wheelchairs—began chanting “No cuts to Medicaid” from the gallery floor. They were quickly taken and escorted out of the room by Capitol Police, who ultimately arrested 26 people for protesting the proposed Medicaid cuts.
Among the dozens of health care changes included in the bill, Section 44126 directly targets Planned Parenthood and similar providers.
That section would prevent Medicaid funds from going to any nonprofit that:
- Primarily offers family planning or reproductive health services,
- Provides abortions beyond the Hyde Amendment exceptions, and
- Received over $1 million in Medicaid reimbursements in 2024.
While the bill does not name Planned Parenthood directly, the organization is the only national provider that fits all three criteria.
“This section prohibits Medicaid funds to be paid to providers that are nonprofit organizations, that are essential community providers that are primarily engaged in family planning services or reproductive services,” the bill states.
If enacted, the measure would block Planned Parenthood from being reimbursed for any Medicaid-covered care, even though abortion services are already excluded from federal funding. That means the Republicans’ reconciliation bill would only serve to prevent low-income Americans from accessing routine and preventative health care.
Nearly two hours into the hearing, just after opening statements concluded, Democratic New Jersey Rep. Frank Pallone, Jr., a ranking member on the committee, motioned to adjourn the markup. The motion failed in a 29-24 vote, with all Republican members present voting against adjournment.
Eleven hours into the hearing, as the committee prepared to take up Subtitle D—the health section of the bill—Pallone motioned to delay debate on the final section until Wednesday morning at 9 a.m. The motion was denied in a 29–24 vote, with all Republicans present voting against it.
The hearing continued through the night and into the afternoon, ultimately stretching to 26.5 hours, ending around 4:30 p.m.
How this would affect patients
According to internal emails released Sunday night by Democrats on the Energy and Commerce Committee, and brought into the hearing by Democratic California Rep. Nanette Barragán, the Congressional Budget Office estimates the reconciliation bill would leave at least 13.7 million more people uninsured by 2034.
That includes millions who would lose coverage due to Medicaid restrictions, reduced eligibility, and the defunding of providers like Planned Parenthood. The estimate also accounts for separate changes the bill would make to Affordable Care Act subsidies and marketplace access. The CBO noted that some of the losses are already expected under current law, but the reconciliation bill would significantly increase the damage.
It is also likely that Planned Parenthood patients would feel the impact immediately.
Planned Parenthood serves more than 2 million people per year, and more than half of those patients rely on Medicaid or other government programs to access care. For many, a Planned Parenthood clinic is their only nearby provider.
The organization reports that 64% of its health centers are in rural or medically underserved areas—regions where patients already face long waits, limited transportation, or few providers that accept Medicaid.
If the bill passes, those patients would no longer be able to use their Medicaid coverage to access services like wellness exams, annual check-ups, birth control, STI testing, or cancer screenings at Planned Parenthood.
The bill would not stop Planned Parenthood from providing care—but it would cut off federal funding, likely forcing clinics to reduce hours, cut jobs, scale back services, or even shut down.
In Virginia, Planned Parenthood Advocates of Virginia officials said nearly 25,000 patients relied on Planned Parenthood health centers for care last year, including STI treatment, cancer screenings, and birth control. The organization also plays a key role in reaching rural and underserved communities that often lack other providers.
“This isn’t about Planned Parenthood,” said Jamie Lockhart, executive director of PPAV. “It’s about whether tens of thousands of Virginians can keep getting the care they count on. No politician should decide who gets health care and who doesn’t. These are personal, private decisions between patients and their providers.”
In 2023 alone, Planned Parenthood centers in Virginia treated 673 chlamydia cases, flagged 53 potential cervical cancer diagnoses, and provided birth control to over 12,000 patients.
“Defunding Planned Parenthood doesn’t save money—it costs Virginia more and leaves people without care,” Lockhart said.
During the House committee hearing, Democratic Texas Rep. Lizzie Fletcher introduced an amendment to strike Section 44126—the provision that would block Medicaid funds from going to certain nonprofit reproductive health providers, such as Planned Parenthood. Fletcher warned that Texas offers a preview of what could happen nationwide.
“Defunding Planned Parenthood is a terrible idea, and sadly, my home state of Texas provides a cautionary tale,” she said.
Fletcher noted that after Texas removed Planned Parenthood from its state Medicaid program in 2021, enrollment dropped by 24%, access to care fell by 39%, and Medicaid births increased.
“The care could not be replaced,” she said. “This is just another way people will lose access to health care.”
The amendment went to a vote but was rejected in a 28–24 party-line decision, with all Republican members present voting against it.
Why this is happening now
The reconciliation bill stems from a budget resolution passed earlier in April that instructed House committees to reduce federal spending across multiple agencies. The Committee on Energy and Commerce was tasked with submitting “changes in laws within its jurisdiction to reduce the deficit by not less than $880 billion for the period of fiscal years 2025 through 2034.”
Republican Speaker of the House Mike Johnson said earlier this month at the Susan B. Anthony Pro-Life America’s gala that the legislation would “redirect funds away from big abortion and to federally qualified health centers,” referring to other types of clinics that provide primary care but often don’t specialize in reproductive health.
In response, McGill Johnson said the idea that other providers can “fill the gap” is unrealistic.
“Planned Parenthood doesn’t get a blank check from the federal government,” she said. “Like other health care providers, Planned Parenthood affiliates are reimbursed for services provided to patients. If Trump and his allies get their way and ‘defund’ Planned Parenthood, thousands of patients who use Medicaid…would not be able to get services at Planned Parenthood health centers.”
What happens next
The House passed the reconciliation bill Wednesday afternoon, in favor of a Republican majority. The legislation now moves to the Senate, where it could be approved with a simple majority under reconciliation rules. If the Senate makes changes, the bill would need to return to the House for final approval. If both chambers pass the same version, it would then go to the White House.
Republican leaders have said they hope to move the bill through the Senate by Memorial Day, with the goal of getting it to President Trump’s desk for a signature by July 4.
Democrats are expected to oppose the provision targeting Planned Parenthood. Meanwhile, McGill Johnson said Planned Parenthood is preparing for a nationwide fight.
“Nineteen million Planned Parenthood supporters in all 50 states are prepared to fight like hell to stop this egregious attack on their health care,” McGill Johnson said. “We’re not going anywhere.”
[Editor’s Note: This article was updated to include local quotes from Planned Parenthood and additional details in length of the House committee hearing.]