Just a week after the Republican Party’s Affordable Care Act repeal bill was dramatically pulled from the House floor, the Senate advanced legislation that will have serious consequences for the reproductive health and family planning abilities of millions across the country. It’s now awaiting President Trump’s signature — and we have his vice president to thank.

On March 30, the Senate passed H.J. Res 43, but only because, without sufficient support, Vice President Mike Pence cast the tiebreaking vote – a constitutional authority he holds as president of the Senate. He voted in favor, with a smile and a wave.

Here’s why that’s so disturbing: H.J. Res 43 would eliminate a regulation that enables Title X family planning grants to go to the most qualified health care providers. The regulation prohibits states from preventing providers from receiving federal funds for reasons that are unrelated to their ability to provide healthcare services. In other words, if a healthcare provider delivers high-quality care, it’s eligible to receive Title X money.

Why is this critical?



Title X providers offer vital services — such as birth control, cancer screenings, and testing for sexually transmitted infections — to 4 million people, regardless of economic status. It’s a publically funded safety net for those who can’t simply go elsewhere. And it works because the network is diverse and includes reproductive health providers, which are often the most qualified and best-equipped to provide this care.

By law, no Title X funds can be used to provide abortion services. But, in more than a dozen states, politicians have moved to block healthcare providers who also provide abortion, like Planned Parenthood and others, from receiving Title X funds. That’s discrimination, and the courts agree . Excluding qualified providers does nothing to help public health. It actually hurts access to needed care

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The Obama administration recognized this, and in December of last year, the Department of Health and Human Services issued its regulation to protect against this discrimination. But the Congressional Review Act gives Congress the authority to simply undo regulations passed late in the previous administration. It used to be an extremely rare move. That’s no longer the case.

Prior to 2017, it had been used to overturn a rule just once. But with Republicans in control of Congress and the White House, the process has become far more common: As of April 3, the president has signed 11 resolutions to overturn Obama-era regulations, with more headed to his desk. That’s how we ended up overturning Title X family planning protections by a margin so narrow — there was bipartisan opposition in the Senate — that the vice president had to step in.

It was a striking moment. Pence ascended the Senate dais, grabbed the gavel, and calmly, proudly, gleefully even, voted in favor of a resolution that will interfere with health care for millions of low-income women and insert ideology into reproductive health care.



But as striking as it was for Pence, it was no surprise at all.