The Senate Parliamentarian ruled on Monday afternoon that the provision prohibiting Medicaid funds from being used to reimburse health clinics that provide abortions can stay in the GOP’s budget reconciliation package. 

Senate Parliamentarian Elizabeth MacDonough approved a similar provision in the GOP healthcare reform package in 2017, but this provision in President Donald Trump’s One Big Beautiful Bill Act is the closest that anti-abortion advocates have come to accomplishing one of their primary objectives of defunding the nation’s largest abortion provider, Planned Parenthood. 

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According to Planned Parenthood’s 2023-2024 annual report, Planned Parenthood clinics across the country received $792 million from government reimbursement and grants, roughly 44% of their total operating budget. Its annual report showed that the organization performed more than 402,000 of the over 1 million abortions in the United States in 2024. 

Although the Hyde Amendment prohibits federal dollars from directly covering the costs of abortions, anti-abortion advocates argue that any money given to a health center that performs elective abortions indirectly subsidizes the procedures due to the fungibility of money.

Sens. Jeff Merkley (D-OR) and Ron Wyden (D-OR), ranking Democrats in the budget process, denounced Republicans as using the budget reconciliation process to push an anti-abortion agenda that would not pass under the normal 60-vote majority.

“Republicans will stop at nothing in their crusade to take control of women’s bodies and deny them the right to make their own health care decisions,” the senators said in a joint statement. “Republicans are trampling the law to force their extremist ideology onto the American people.”

Sen. Patty Murray (D-WA), a leading abortion rights advocate in the Senate, issued an amendment Monday afternoon during the Senate’s vote-a-rama session, amending the bill in an attempt to remove the defunding language.

“Republicans bill will cut millions of women off from birth control, cancer screenings, essential preventive health care, care that they will not be able to afford anywhere else, and it will shutter some 200 health care clinics in our country, and it will take another step towards enacting Republicans plan for a back door nationwide abortion ban,” said Murray. 

Murray’s measure failed by 49-51.

Sen. Cindy Hyde-Smith (R-MS) challenged Murray’s motion, citing that the language of the bill does not directly target Planned Parenthood.

“There was a time when protecting American tax dollars from supporting the abortion industry was an uncontroversial, non-partisan effort that we could all get behind even if we had opposing views on protecting the dignity of human life,” said Hyde-Smith. 

The bill originally prohibited Medicaid funding for abortion providers for a full 10 years, but the statute was revised to only prohibit funding for one year, according to Hyde-Smith. 

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“If a medical provider wishes to stay within the Medicaid program, it should simply cut elective abortion procedures from its services,” said Hyde-Smith.

Anti-abortion advocates highlight that federally qualified health centers that already receive Title X family planning funding and Medicaid reimbursement outnumber Planned Parenthood centers 15 to 1.