If the Senate version of the “big, beautiful bill” becomes law as President Donald Trump and Republican leaders in Congress hope, Planned Parenthood would not be eligible to receive Medicaid funding for at least a year.

The change threatens the nationwide network of health care facilities, including four in Georgia, which offer services ranging from sexually transmitted disease prevention and birth control to cancer screenings.

Planned Parenthood’s position as the country’s leading provider of abortions has put the organization in conservatives’ crosshairs, but that is a fraction of the services it provides. Some of its clinics don’t perform abortions at all.

However, all of these clinics are in peril if the “defund” language becomes law, executives in the organization say.

Federal law already forbids federal dollars from being used for abortions, even at Planned Parenthood, so the money the organization gets from the federal government is used for other services. But anti-abortion advocates have spent decades pushing to keep federal money away from any facility that offers the procedure.

Rep. Buddy Carter, a Republican from Georgia, said limiting funding to Planned Parenthood was a “red line” for some of his GOP colleagues to agree to support the spending bill.

“Obviously I’m pro life, and I agree that the taxpayers money shouldn’t be going toward that,” Carter said.

Planned Parenthood Action Fund President and CEO Alexis McGill Johnson said during a recent news conference that the federal spending proposal could cause nearly 200 facilities to close across 24 states. She did not specify in which states those closures could occur.

“Closures could eliminate one in four abortion providers nationwide, effectively enacting a backdoor abortion ban, even in states where abortion remains legal,” Johnson said.

If Planned Parenthood is forced to close clinics, remaining health care facilities “cannot absorb the millions of patients Planned Parenthood serves,” she said.

Planned Parenthood operates 600 clinics across the nation through a network of 48 affiliates. Planned Parenthood Southeast, based in Atlanta, is responsible for five Alabama and Georgia clinics in East Atlanta, Marietta, Lawrenceville, Savannah and Birmingham, plus virtual clinics providing services to patients in both states.

A study by the Guttmacher Institute, a New York-based nonprofit research organization that supports abortion rights, determined that “federally qualified health centers” would need to increase their caseloads by 56% — which would be an additional 1 million contraceptive patients — to serve those who could no longer be seen at a Planned Parenthood clinic.

Federally qualified health centers are community-based facilities that receive federal funding to provide care in underserved neighborhoods.

Planned Parenthood Southeast Advocates, the political and advocacy arm of the organization, recently highlighted the work performed across Georgia and Alabama the last year. In 2024, Planned Parenthood Southeast served more than 14,000 patients across nearly 20,000 visits.

In addition to providing surgical and medication abortions, they distributed more than 4,300 packs of oral birth control, administered nearly 16,000 sexually transmitted disease tests, nearly 1,000 cervical cancer screenings and almost 1,400 clinical breast exams.

“There is no secret that this is the most important time to protect sexual and reproductive health care right here in the Southeast,” Mairo Akposé, interim president and CEO of the affiliate, said during a recent fundraising gala. “We are in the most hostile territory, but we will continue standing for our patients and we need you to stand with us.”

Planned Parenthood officials say their facilities act as a health safety net in some of the country’s lowest-income areas. In Georgia, Alabama and Mississippi in 2024, 72% of patients were uninsured or underinsured. About 63% of patients served live at or below the federal poverty line.

“We are such a critical part of the public health infrastructure,” Johnson said. “We literally are a health system that strengthens the public health care infrastructure.”

The spending package passed by the Senate does not identify Planned Parenthood by name. But it prohibits entities that perform abortions and also have received more than $800,000 in Medicaid funding during the 2023 fiscal year from receiving any additional Medicaid funding for one year beginning on the date the bill becomes law. Using those measurements, Planned Parenthood is the only organization affected.

Earlier versions of the reconciliation bill defunded Planned Parenthood for 10 years, and some Christian conservatives have criticized the change made in the Senate bill.

Tony Perkins, president of the Family Research Council, said he was no longer in support of the legislation and cited the reduced timeline for blocking dollars to Planned Parenthood as one of his concerns. In a post on X, he said Congress could do better than the Senate bill and that the organization may decide to keep track of which lawmakers vote for the bill.

“The ‘One Big Beautiful Bill’ has lost its glamour in the Senate,” Perkins wrote. “Gone is the defunding of Planned Parenthood, because let’s be honest — a one-year pause in federal funding is not defunding.”

The fate of the bill now lies with the House, which is considering whether to pass the Senate version as-is or make changes that would send the bill back to the Senate. Trump has said he wanted the legislation on his desk to be signed into law by July 4, but on Monday expressed an openness to giving Congress more time to work on a final agreement.

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