[Congressional Record Volume 163, Number 36 (Wednesday, March 1, 2017)]
[Senate]
[Pages S1526-S1529]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                       Family Planning Providers

  Mrs. MURRAY. Mr. President, thank you, and thank you to some of my 
colleagues who are going to be joining me on the floor this afternoon.
  The day after President Trump was inaugurated was one of the most 
inspiring I have ever gotten a chance to be part of. Millions of 
people, men and women, marched in Seattle, in Washington, DC, and in 
cities and towns in between. They carried signs, they chanted, and they 
made it absolutely undeniably clear that when it comes to women's 
rights and healthcare, people across the country do not want to go 
backward. Since then, they have continued to speak up and stand up.
  But we are here today because Donald Trump and Republicans in 
Congress simply are not getting the message. I want to discuss one 
crucial example in particular--the possibility that in a matter of 
days, Senate Republicans could roll back a rule protecting family 
planning providers from being discriminated against and denied Federal 
funding.
  Let me start by explaining a bit about what family planning providers 
mean to our community. These providers--part of the Title X program, 
which has bipartisan history--deliver critical healthcare services 
nationwide but are especially needed in rural and frontier areas. In 
2015 alone, Title X provided basic primary and preventive healthcare 
services, such as Pap tests, breast exams, birth control, and HIV 
testing, to more than 4 million low-income women and men at nearly 
4,000 health centers. In my home State of Washington, tens of thousands 
of patients are able to receive care at these centers each year. They 
often have nowhere else to turn for healthcare. In fact, 4 out of 10 
woman who receive care at health centers funded by Title X consider it 
to be their only source of healthcare.
  Taking resources away from these providers would be cruel. It would 
have the greatest impact on women and families who are most in need. 
But that is exactly what the law passed in the House, which is now on 
its way to the Senate, would mean. It would undo a valuable effort by 
the Obama administration to ensure that healthcare providers are 
evaluated for Federal funding based on their ability to provide the 
services in question, not ideology. In doing so, the bill would make it 
even easier for States, led by extreme politicians, to deny family 
planning providers Federal funding, not because of the quality of the 
care they provide or the value to the communities they serve but based 
on whether the politicians in charge agree that women should be able to 
exercise their constitutionally protected rights to safe, legal 
abortion.

[[Page S1527]]

  It is the 21st century. It is time for politicians to stop telling 
women what they can and can't do with their own bodies. That is what 
the women and men who have been marching and speaking up all over our 
country believe. That is what I believe. It is what Democrats believe.
  If Leader McConnell thinks he can rush this harmful legislative 
effort through without a fight, we are here to say he is wrong. He can 
expect Democrats and maybe even some Republicans who are concerned 
about losing healthcare providers in their own States to fight back. So 
today I am calling on the leader to commit right now to drop this 
effort and agree not to bring this bill to the floor. It is well past 
time that extreme Republicans end their damaging political attacks on 
women. I think the opportunity to start that is right this minute. So 
we urge him to take this action and not bring this to the floor. We 
want him to know that we are going to fight back every step of the way 
if he does.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Mrs. SHAHEEN. Mr. President, I came to the floor to join my colleague 
and friend Senator Murray to say that I, too, am ready for this fight 
to oppose S.J. Res. 13, which would allow the discrimination against 
Title X family planning providers. This is a misguided measure that 
would leave millions of women and families with fewer healthcare 
options. It would drastically decrease women's access to basic primary 
and preventative health services, including lifesaving cancer 
screenings and HIV testing.
  Make no mistake, as Senator Murray said, the primary target of this 
legislation is Planned Parenthood. For years now, Republican leaders in 
Congress have tried to keep women from choosing Planned Parenthood as 
their healthcare provider--this at a time when Planned Parenthood 
serves millions of women nationwide, including nearly 12,000 women in 
New Hampshire, my home State. Most of the women in New Hampshire have 
incomes below or near the poverty line. Many of those women live in 
rural areas where they don't have other options for healthcare 
coverage.
  The sad irony of this attack on Planned Parenthood is that study 
after study has shown that cutting back access to birth control and to 
other family planning methods actually increases the number of 
abortions. So I understand that opponents are interested in supporting 
this legislation because they think Planned Parenthood provides 
abortions, but the coverage Planned Parenthood is providing to women in 
New Hampshire and across this country with Federal dollars does not 
allow for abortions. So what we are doing is taking away women's access 
to contraception and to other family planning services and saying: You 
have no choice now.
  More than ever right now, facts matter. Research matters. Talking 
away women's access to birth control and family planning will lead to 
more abortions, not fewer abortions. Yet this legislation is part and 
parcel of a broader national campaign against Planned Parenthood, whose 
clinics have been the target of vilification, of threats, and of 
violence. In October of last year, the Planned Parenthood clinic in 
Claremont, NH, was vandalized not once but twice. The second attack, a 
breaking-and-entering incident, caused extensive damage. It forced the 
clinic to close for 5 weeks.
  I have great admiration for the courage of doctors and other 
healthcare providers at the Claremont clinic. Despite threats and 
attacks, they are determined to continue serving women across the 
Connecticut River Valley, many of whom have no alternative to the 
Claremont clinic. They are typical of the dedicated healthcare 
professionals at Planned Parenthood clinics all across our country.
  The good news is that, according to poll after poll, the American 
people across the political spectrum--from Independents, to 
Libertarians, to Democrats, to Republicans--strongly support Planned 
Parenthood and oppose efforts to take away women's ability to choose 
Planned Parenthood as their healthcare provider.
  At last night's Presidential address to Congress, I was honored to 
have as my guest Jennifer Frizzell of Planned Parenthood of Northern 
New England. Jen knows exactly what is at stake for women if President 
Trump and Republican leaders succeed in closing hundreds of Planned 
Parenthood clinics across the United States.
  So let's be clear again: Supporting family planning clinics is not 
about abortion, which by law is never funded by taxpayer dollars--
something that I think is often misrepresented by some of our 
colleagues here in Congress. What this is about is ensuring that 
American women have access to the basic healthcare they need. For 40 
percent of women, their visits to a family planning center is the only 
care they receive annually. In 2015 alone, Title X provided basic 
primary and preventive healthcare services, such as Pap tests, breast 
exams, birth control, and HIV testing, to more than 4 million women and 
men at nearly 4,000 health centers.
  I am sure that every one of our colleagues is receiving letters and 
emails and phone calls from constituents on this issue. They are 
pleading with us not to take away their access to Planned Parenthood 
and the healthcare they trust and depend on.
  I received this message from Caitlin Parnell of Hampstead, NH. She 
said:

       As a young mother of a 2-year-old, my husband and I knew we 
     wanted to wait to have more children. We were both working 
     full time but barely making ends meet. The companies we 
     worked for offered health insurance, but they were small 
     companies, and the monthly cost was well more than we could 
     afford. So we went without. With no insurance, I turned to 
     Planned Parenthood for birth control. With the sliding pay 
     scale, I was able to get exams and birth control within my 
     budget. We were able to decide the best time to have more 
     children, which also allowed us to responsibly manage our 
     finances as well. An unplanned pregnancy at that point would 
     have destroyed the little financial stability we had. I don't 
     know where our family would be without Planned Parenthood.

  Karla Canderhoof is a stay-at-home mother in Newfields, NH. She wrote 
this:

       After being diagnosed with ovarian cyst issues that caused 
     debilitating pain, I turned to Planned Parenthood for 
     treatment. In my case, the treatment for ovarian cysts was 
     birth control. At the time (during my college years) I could 
     not afford the cost of birth control due to my lack of 
     insurance. But Planned Parenthood gave me birth control free 
     of charge.

  Amanda Arel of Rochester, NH, sent this message:

       During the ages of 22 to 25, I utilized Planned Parenthood 
     for my annual exams and birth control. As I did not have 
     insurance and was in college, I was not able to afford most 
     medical care. Planned Parenthood not only provided me with 
     essential care, they made it very comfortable for me and were 
     very knowledgeable and answered any questions I had. They 
     provided birth control for me that, if it wasn't for them, 
     I would not have been able to get, at a cost I could 
     afford.

  I still support Planned Parenthood because they provide safe, 
affordable healthcare for all, and that is so important.
  We need to listen to our constituents, those who are speaking out in 
passionate support of Planned Parenthood and other family planning 
clinics.
  As Senator Murray said so eloquently, this is about respecting 
women's access to healthcare services, including those millions of 
vulnerable women who have nowhere else to turn for essential care. This 
is also about respecting women's constitutionally protected right to 
make our own reproductive choices. We must not allow Congress to strip 
away Federal investments in family planning clinics by allowing States 
to discriminate against providers like Planned Parenthood.
  I urge our Republican colleagues, don't bring S.J. Res. 13 to the 
floor. If it does come to the floor, I certainly intend to join in the 
fight with my colleagues--Senator Murray, Senator Blumenthal, and so 
many other Democrats and, I believe, Republicans--to defeat this 
legislation.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I am proud and honored to follow my 
very distinguished colleague from New Hampshire, Senator Shaheen, and 
Senator Murray of Washington in this cause which invokes a line that I 
think the President used last night in his address to us, pledging 
cooperation for causes where we can make a common cause.
  Surely no cause is more important than healthcare, no goal is more 
important than preventive services for

[[Page S1528]]

women so we can all avoid the costs not only in dollars and cents but 
the cost of human suffering and foreclosed futures that will come when 
women are denied these kinds of basic services.
  I met this morning with a group from Planned Parenthood, patients and 
providers working in clinics across New England. They told me their 
story--some of them patients, some of them service providers and 
volunteers--about the kind of transformative effect that primary care, 
examinations and screenings, can have for women who would otherwise 
lack those services. The community health centers cannot substitute for 
them.
  Family planning programs under title X are often the only Federal 
programs dedicated to providing comprehensive services in family 
planning but also in related preventive health services.
  Over the past year alone, title X providers have provided cancer and 
HIV screenings, contraceptive services, and other primary and 
preventive services to over 4 million women and men at nearly 4,000 
health centers in New England and across the country. This network of 
healthcare providers is a safety net. They compose a network, the title 
X network, including providers of State and local health departments, 
federally qualified health centers, and family planning councils. They 
create a network that provides a critical source of healthcare to 
people who otherwise would be denied it. They are trusted providers who 
are willing to serve the uninsured, the uninsured and low-income 
individuals who risk losing all access to healthcare if it was not for 
this network.
  These clinics are often the only healthcare providers in rural areas 
and other parts of the country. So the political attacks on providers 
that provide abortion services would mean a loss of access to all 
family planning and preventive healthcare in these parts of the 
country--rural, metropolitan, suburban. Not only are these services 
necessary, but family planning services are really good investments, 
especially when it comes to the money that otherwise would be spent 
when illnesses or diseases become more serious.
  In 2010, the $1.14 billion that was spent in this country on family 
planning resulted in more than $8 billion in gross savings. That is a 
clearly worthwhile investment.
  The resolution that passed the House last month that Senator 
McConnell is considering bringing to the Senate floor would eliminate 
protections that prevent discrimination against these very providers, 
discrimination based on facts or sometimes nonfacts that have nothing 
to do with the quality of care or the worthiness of the investment in 
these clinics and healthcare providers.
  The regulation that Republicans are seeking to eliminate ensures that 
no qualified providers will be excluded from eligibility for Federal 
funding for discriminatory reasons outside of that provider's ability 
to provide care. That is really the criterion that matters. The ones 
who want to eliminate this regulation apparently would rather risk 
limiting access to healthcare in order to score political points. 
Unfortunately, it is really that simple.
  At a time when Republicans continue to try to push ahead with 
repealing the Affordable Care Act, which also includes essential 
support for preventive healthcare, they also want to disrupt the 
country's healthcare system for this kind of women's healthcare.
  Just last night, after President Trump claimed he wanted to work with 
Members of both parties to invest in women's health, we are threatened 
with this step to eliminate an important regulation that protects 
women's health. I ask the President and my colleagues across the aisle 
to join in this common cause, which should unite us on a bipartisan 
basis. If they want to continue these attacks, we are ready for the 
fight, but we would much rather cooperate and collaborate in the cause 
of women's healthcare.
  I urge my Senate colleagues to listen to the kind of providers and 
patients whom I met with this morning, the kind of provider that 
Senator Shaheen brought with her last night as her guest, the kind of 
providers and patients and volunteers who work in these clinics all 
across the country, whether it is Planned Parenthood or other kinds of 
clinics. I ask them to listen to the advocates here, supporters, like 
the National Coalition of STD Directors, the National Campaign to 
Prevent Teen and Unplanned Pregnancy, the American Psychological 
Association, the National Association of County and City Health 
Officials, the ACLU, and the American Medical Student Association. They 
are just a few of the stakeholders who advocate strongly that this 
regulation be continued and who oppose the step the House passed and 
that the majority leader may bring to the floor.
  These people have dedicated their lives and their careers to 
assisting the vulnerable, whether they are providing healthcare or 
legal services or other kinds of support, and they are saying to us: Do 
not eliminate this regulation. I think we ought to listen to them. I 
hope my colleagues will.
  I am determined that we will fight tooth and nail if we need to do 
so, but I would much rather that we follow the President's offer and 
that we collaborate to stop the elimination of this regulation, which 
is so important to making sure that women's healthcare is based on 
quality, not on discriminatory reasons based on political motive.
  The PRESIDING OFFICER. The Senator from Maine.
  Mr. KING. Mr. President, I rise to oppose S.J. Res. 13, which is a 
Congressional Review Act resolution to undo the regulations which 
protect title X health centers. I believe this resolution, although 
well meaning, will have the opposite effect of its intention.
  I particularly want to discuss the organization known as Planned 
Parenthood, but, more generally, these women's health centers, these 
title X health centers, No. 1, provide many healthcare services to 
women, particularly low-income women. They are the choice of those 
women. They are a place they have chosen to go to receive their 
healthcare treatment.
  I do think that one of the problems with this whole debate is the use 
of the term ``funding'' of Planned Parenthood. What we are talking 
about here is not funding, as in a budget line or a budget provision 
that says: Planned Parenthood gets $58 million or $100 million or $10, 
whatever it is. That is not the way it works. What we are talking about 
is reimbursement for women's healthcare services provided on an 
individual, case-by-case basis, and this does not include abortion. It 
does not include abortion.
  These organizations in Maine--Planned Parenthood, for example, serves 
10,000 people. Ten thousand women choose to get their healthcare 
services from Planned Parenthood.
  The other piece of this debate I have never understood is why those 
who are opposed to abortion would be so opposed to organizations that 
allow women to make choices about pregnancies and provide contraception 
and contraception advice, which statistically we know reduces abortion.
  In Maine, because of the access to organizations like Planned 
Parenthood and other women's healthcare clinics, we have seen our teen 
pregnancy rate drop 58 percent in the last 20 years or so--58 percent. 
That is a significant reduction, and it is attributable, at least in 
some significant part, to the availability of the services provided by 
these organizations.
  It has always struck me as ironic, in the extreme, that someone who 
says they are against abortion should be against an agency that 
provides contraception and family planning services that prevent 
pregnancy and therefore prevent abortion.
  I subscribe to President Clinton's formulation that abortion should 
be safe, legal, and rare. It should not be something that is chosen 
just casually--and of course it isn't. This is a terribly difficult 
decision for a women, but that is not the subject today. The subject 
today is curtailing the reimbursement for women's healthcare services 
to an organization or organizations that may also provide abortion 
services.
  It is contrary to the very idea of trying to prevent abortion, but it 
is also denying healthcare services of choice to thousands of women in 
Maine and millions across the country.
  I have sat in this body for 4 years and heard people talking about 
how consumers and patients should be able to choose their physicians, 
they should be able to choose their healthcare options. This was a 
basic principle. It is one of the arguments we have heard as we have 
been discussing other healthcare

[[Page S1529]]

issues in this body. This Congressional Review Act provision would take 
away that choice. I think that is a great disservice to those citizens, 
many of whom are low income, many of whom are covered by Medicaid, many 
of whom do not have private health insurance. To take this step that 
this resolution would entail would be very shortsighted, and I believe 
it is a violation of the rights of those people to choose their 
healthcare providers.

  It also does not achieve the ends that the sponsors want to achieve. 
That is why I believe that this resolution--although it may be 
denominated as something to do with being anti-abortion, I think it is 
just the opposite. If this resolution passes and these healthcare 
centers under Title X, including Planned Parenthood, are unable to 
deliver these services, there will be more unwanted pregnancies and 
more abortions. I think that is a sad and unfortunate outcome to be 
perpetrated by people who say they are trying to oppose abortion.
  Planned Parenthood provides women's healthcare services. It provides 
contraceptive services. I know the people in Maine who work for this 
agency, and I know this is a terribly controversial issue, but I 
believe that if what we want to do is minimize the number of abortions, 
then it makes no sense whatsoever to somehow indiscriminately strike 
out at the funding of the agencies that provide healthcare services.
  Nobody in this body is talking about Federal funds for abortion. That 
is not what the issue is. If that were the issue, this would be an 
entirely different debate. The issue is taking reimbursement away from 
the Planned Parenthood clinic or Title X clinic for mammograms, 
cervical exams, or other women's healthcare services. Why would we want 
to do that in the name of achieving some other goal that won't even be 
achieved? In fact, it will be made a more widespread issue.
  I hope the Senate will realize that whatever the motivation behind 
this provision is, it just makes no sense. It makes no sense from the 
point of view of preventing abortion. It makes no sense in terms of the 
taxpayers. Preventive services, contraceptive services, cost about $200 
a patient; a Medicaid birth costs about $10,000. If it is a Medicaid 
patient, those are taxpayer dollars. We are talking about saving 
taxpayers money.
  This goes to the healthcare system in general: Why would we want to 
undo prevention, whether prevention of unwanted pregnancies or 
prevention of a disease? Prevention is part of the solution to the 
healthcare crisis in this country because of the excessive cost.
  Here is a specific case. Again, we are not talking about funding 
abortions. We are not talking about funding Planned Parenthood. We are 
not talking about funding these Title X health centers. We are talking 
about protecting them in terms of their reimbursement for women's 
health services delivered. That is what this vote is about. If you vote 
for this, you are voting to take away reimbursement for health services 
that are necessary to protect the health and well-being of women across 
this country.
  I hope my colleagues will vote no on this resolution, and I believe 
it will serve the public and it will even serve those people who are 
concerned most deeply--and I understand--about abortion. If you want 
fewer abortions, fund Planned Parenthood. It seems to me that is a 
fairly clear correlation, and it is one we should respect. But we also 
should respect the rights, needs, and choices of those millions of 
women who rely on these clinics for their healthcare needs aside from 
the issue of reproductive rights, just straight healthcare needs. That 
is what this vote is all about.
  Thank you, Mr. President.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Toomey). Without objection, it is so 
ordered.
  Mr. WHITEHOUSE. Mr. President, I ask unanimous consent to speak for 
up to 15 minutes as in morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.