“If past is prologue, we could see a number of congressional attacks targeted not just to Planned Parenthood but that will compromise the sustainability of the entire family planning safety net,” said Audrey Sandusky, director of advocacy and communications for the National Family Planning & Reproductive Health Association.

Rep. Diane Black (R-TN), sponsor of the House resolution and key Affordable Care Act (ACA) repeal leader who recently said her colleagues won’t replace the law’s popular birth control benefit, admitted that she couldn’t remember the last time she had visited a Planned Parenthood.

Alex Wong / Getty Images

Republicans in the U.S. House of Representatives on Thursday forced a nearly party-line 230-188 vote to overturn President Obama’s attempt to safeguard federal funding for family planning clinics, including Planned Parenthood affiliates, allowing them to seamlessly continue serving people with low incomes.

The U.S. Department of Health and Human Services finalized the rule in the last weeks of the Obama administration—opening it up to repeal through the Congressional Review Act (CRA), an arcane procedural tool that GOP lawmakers can use to undo the last six months of Obama-era regulations within the first 60 days of the new Congress and with a Republican president willing to sign off on their efforts. The rule clarified existing law and sent a clear message that states can’t stop reproductive health-care providers from receiving federal Title X funds if they offer abortion care.

Officials in many states have tried to block the funds in their quest to take down Planned Parenthood. The health-care organization’s affiliates treat about 1.5 million Title X patients—“roughly one third of the more than 4 million people served by the program,” according to a Planned Parenthood Federation of America statement.

The U.S. Senate still needs to take up and pass the Title X resolution of disapproval before it can become law.

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A spokesperson for Majority Leader Mitch McConnell (KY) would only reiterate that the top Senate Republican hasn’t yet announced the next regulation up for repeal under the CRA. McConnell would likely take up the House-passed measure (HJ Res. 43), though Sen. Joni Ernst (R-IA) introduced an identical Senate version (SJ Res. 13).

Overturning the rule requires a 51-vote majority to pass the Senate. Should mixed-choice Republican Sens. Susan Collins (ME) and Lisa Murkowski (AK) defect, Vice President Mike Pence would have to cast a tie-breaking vote, as he did to confirm GOP mega-donor Betsy DeVos to helm the U.S. Department of Education.

“Overturning the rule emboldens states to discriminate against providers in the Title X network for a variety of reasons irrelevant to the provision of high-quality family planning services,” Audrey Sandusky, director of advocacy and communications for the National Family Planning & Reproductive Health Association (NFPRHA), told Rewire in an email.

GOP Messaging Touts “Alternative Facts”

A House Rules Committee hearing Tuesday to set the terms of floor debate ahead of the vote gave Republicans a platform to advance false anti-choice claims.

Rep. Diane Black (R-TN), sponsor of the House resolution and key Affordable Care Act (ACA) repeal leader who recently said her colleagues won’t replace the law’s popular birth control benefit, admitted that she couldn’t remember the last time she had visited a Planned Parenthood.

Rep. Tim Walberg (R-MN), who believes that “abortion is not health care,” claimed the resolution represented a bipartisan effort. But the resolution garnered the support of only two Democrats: Rep. Dan Lipinski (IL) and Rep. Collin Peterson (MN), a longtime abortion rights foe with a 9 percent NARAL Pro-Choice America rating.

Freshman Rep. John Faso (NY), who has voiced concerns about the GOP’s intent to defund Planned Parenthood as part of ACA repeal, was one of two Republicans to vote against the resolution.

Meanwhile, 161 House Democrats—most of the 193-member caucus—signed on to a letter demanding that House Speaker Paul Ryan (R-WI) halt the “unprecedented attack” on reproductive health care. Before interference from GOP-controlled state legislatures, they wrote, Republican and Democratic administrations alike directed federal Title X funds to family planning providers based on their ability “to deliver high-quality care”—not on whether that high-quality care included abortion.

“At a time when millions of constituents are phoning, showing up at our offices, and doing everything they can to stop Congress from ripping away their health care, Republicans must be entirely tone-deaf as they prepare to take this step, “ Rep. Diana DeGette (D-CO), co-chair of the House Pro-Choice Caucus, said in a statement.

Congressional Republicans attacked the Title X rule, seemingly drawing inspiration from their state-level counterparts.

House Majority Leader Kevin McCarthy (R-CA), the chamber’s number two behind Ryan, mischaracterized the rule as “the Title X abortion funding rule” in a press release riddled with misinformation, or “alternative facts.”

McCarthy failed to note that the Hyde Amendment prohibits most federal funds from going to abortion care except in rare circumstances. The discriminatory ban disproportionately affects people with low incomes and people of color—often, the very same populations in need of preventive care from the Title X providers under assault.

Family planning providers served four million patients in 2015, according to U.S. Department of Health and Human Services data. That total includes 30 percent who self-identified as Black or African American, Asian, Native Hawaiian or Pacific Islander, or American Indian or Alaska Native; 32 percent who self-identified as Hispanic or Latino; and 13 percent who had limited English proficiency.

And “no one,” as the progressive Center for American Progress recently stressed, “can be refused because of their inability to pay.”

Advocates Anticipate Further Battles

An annotated version of McCarthy’s press release would look something like this: “Overturning this rule does not reduce funds for the Title X program”—an action McCarthy’s colleagues have repeatedly sought through the appropriations process—“but only allows states to redirect those funds to community health centers and hospitals that offer more comprehensive coverage”—an anti-choice myth that Rewire and the Washington Post have debunked in coverage of a separate GOP plan to “defund” or strip Planned Parenthood of Medicaid reimbursements as part of its ongoing ACA repeal efforts.

“Community health centers, though they make up a vital part of the health-care landscape, are not prepared to fill the gap in care that would be created should Planned Parenthood lose its funding,” Rewire’s Ally Boguhn wrote in an analysis.

Sandusky said advocates are “bracing for a bruising budget and appropriations battle ahead and have good reason to anticipate either a significant funding cut or full elimination of Title X, our nation’s family planning program, in a White House budget and/or congressional budgets.”

“If past is prologue, we could see a number of congressional attacks targeted not just to Planned Parenthood but that will compromise the sustainability of the entire family planning safety net,” Sandusky said.