WASHINGTON ― Since former President Barack Obama signed the Affordable Care Act in 2009, making birth control free for millions of women, unintended pregnancies fell 18 percent and the U.S. abortion rate reached a record low.

Now, Republicans have proposed a replacement for Obamacare, which ― in the name of restricting abortion ― could have the opposite effect. The bill “defunds” Planned Parenthood, one of the leading providers of affordable contraception in the nation, by preventing Medicaid from reimbursing Planned Parenthood for its health and family planning services to poor women. And it would dramatically roll back Medicaid coverage in general, which accounts for three-quarters of all public dollars spent on family planning and pays for nearly half of U.S. births.

“This bill would be devastating to reproductive health for low-income Americans,” said Adam Sonfield, senior policy director for the Guttmacher Institute.

Kathleen Sebelius, former secretary of health and human services under Obama, said she finds the plan “baffling.”

“In the seven years since the Affordable Care Act has been passed, women have had access to contraception, including the whole range of services that the FDA has authorized,” she said. “And when teenagers for the first time could qualify for preventive care, which included contraception, the numbers of unplanned pregnancies and the numbers of abortions and the numbers of teen pregnancies have dropped dramatically in this country. So one could argue that by removing some of those features, the people who at least profess to be anti-abortion are actually going to be driving those numbers back up.”

If “TrumpCare” did drive unintended pregnancies back up, for women who choose abortion the procedure would likely not be covered by insurance. The plan would essentially drive abortion coverage out of the individual insurance market by barring individuals and small businesses from using their federal tax credits to purchase an insurance plan that covers the procedure. It would cost a person upwards of $2,000 more per year to buy a health insurance plan that includes abortion coverage, which means that hardly anyone will buy those plans, and insurance companies will have little incentive to offer them at all.

“It’s a real, I would say, direct government interference in anyone being able to select a plan that actually meets their needs and meets their own religious view of the world,” Sebelius said.

Republicans are going to have trouble passing their bill if it defunds Planned Parenthood: They have already lost the support two of their own female senators, Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine), over the provision. They need 60 votes to advance the legislation, there are only 51 of them in the Senate, and they are unlikely to win over any Democrats by slashing family planning and Medicaid.

The New York Times reported on Monday that President Donald Trump, who has strongly endorsed the GOP’s plan, offered Planned Parenthood the chance to keep its Medicaid reimbursements if it stops offering abortion services.

“As I said throughout the campaign, I am pro-life and I am deeply committed to investing in women’s health and plan to significantly increase federal funding in support of non-abortion services such as cancer screenings,” Trump said. “Polling shows the majority of Americans oppose public funding for abortion, even those who identify as pro-choice. There is an opportunity for organizations to continue the important work they do in support of women’s health, while not providing abortion services.”

Trump’s statement is misleading ― it’s already illegal for federal money to pay for abortions. And a recent Quinnipiac poll showed that 62 percent of Americans oppose defunding Planned Parenthood, while only 31 percent would support the move.

Dawn Laguens, the executive vice president of the Planned Parenthood Federation of America, said the family planning provider rejected Trump’s offer.

“Offering money to Planned Parenthood to abandon our patients and our values is not a deal that we will ever accept,” she said. “Providing critical health care services for millions of American women is nonnegotiable.”