Senate Republicans and other key players involved in negotiations over the One Big Beautiful Bill Act have struggled to provide a clear explanation for why the provision defunding Planned Parenthood was limited to just one year.

The last-minute decision to shorten the defunding measure came as a partial disappointment to some anti-abortion advocates, who have long sought to remove federal funding from Planned Parenthood, the nation’s largest abortion provider by far.

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The change mars what is otherwise a landmark victory for the movement, as advocates have worked for years to cut government support for Planned Parenthood, which received $792 million in government funding in 2023 and could face difficulties from losing federal contributions for one year. Federal law already prohibits funding for abortions in most cases. The measure in question limits Medicaid family planning reimbursements to large entities that provide elective abortions.

Activists are disappointed that an extended defunding period appeared to be within grasp just days before final passage, as the House version of the bill would have cut off funds for 10 years. Reasons for the change have not been explained in detail.

“Going from 10 years to one year is a big decrease in the effectiveness of this, because now we’re going to have to do it again next year, and that brings its own challenges,” said Noah Brandt, vice president of communications at the anti-abortion group Live Action.

Senate Republicans, asked by the Washington Examiner, said that the provision was changed to comply with rulings by the Senate parliamentarian about what was eligible to be passed through reconciliation, the special budget process that Republicans used to advance the bill in the Senate to avoid a Democratic filibuster.

However, Republicans in leadership and relevant committees declined to provide an on-the-record explanation of what specific procedural considerations made it necessary to limit the change to just one year.

Abortion policy and the Byrd rule

The procedural guardrail that governs eligibility of provisions for the reconciliation process is known as the Byrd Rule.

Generally speaking, the Byrd Rule prevents any “extraneous matter” that does not directly affect the budget from being included in the reconciliation process.

As Republicans advanced the bill through reconciliation, Democrats could have raised a point of order against any measure the parliamentarian deemed not compliant with the Byrd Rule. Defeating such a point of order would require 60 votes, meaning that Democrats could band together with their 47 chamber members to strip any Byrd-noncompliant provision from the bill.

In the lead-up to the vote, Republicans and Democrats negotiated with parliamentarian Elizabeth McDonough over the status of dozens of provisions with respect to the Byrd Rule, including the Planned Parenthood defunding measure.

Following those closed-door negotiations, the final bill text was revised to shorten the defunding to just one year.

The parliamentarian’s office does not generally communicate with the press. On background, Senate sources said that Byrd Rule considerations led to the change, but did not cite which specific provisions of the rule factored into the move.

It is worth noting that Republicans were able to rework several provisions that were initially deemed noncompliant with the Byrd Rule and have them included in the final legislation. For example, Republicans could rewrite a provision transferring the space shuttle Discovery to successfully make it law.

At one key juncture, Republicans effectively brushed aside a negative ruling from the parliamentarian to make the main tax cuts in the bill permanent—a form of procedural strong-arming that could, in theory, have been used for any provision in the bill.

Possible Byrd violations

Spokespeople for Senate Majority Leader John Thune (R-SD) and Senate Finance Committee Chairman Mike Crapo (R-ID) declined the Washington Examiner‘s request to provide an on-record accounting of why the 10-year provision was judged not to comply with the Byrd Rule.

Sen. Lindsey Graham (R-SC), chairman of the Budget Committee responsible for parliamentary negotiations, did not respond to a request for comment.

But outside observers suggested that one possibility is that the 10-year defunding ran afoul of the “merely incidental” requirement of the Byrd Rule, which mandates that policies included in reconciliation legislation primarily affect taxation or spending, rather than producing substantive policy or regulatory changes.

Specifically, the Byrd rule requires the parliamentarian to weigh whether the policy’s fiscal effects are “merely incidental to the non-budgetary components of the provision.”

Bill Hoagland, senior vice president of the Bipartisan Policy Council, told the Washington Examiner that the “merely incidental” portion of the Byrd rule has “always created heartburn for parliamentarians” because it is up to interpretation.

“The question always comes down to a value judgement, in some ways, by the parliamentarian, as to whether this really is a budget issue, or are you putting this in more for because you couldn’t get the policy through under normal, regular order,” said Hoagland. 

One reason the defunding policy might have run afoul of the “merely incidental” provision is that it could shift patients from Planned Parenthood clinics to other healthcare centers within the federally subsidized family planning network. 

Sources confirmed for the Washington Examiner that the issue of patient displacements from Planned Parenthood closures was a concern on both sides of the aisle as the bill moved through the legislative process. No one knows how the measure will affect patients and women’s health providers.

In the lead-up to the bill’s passage, Planned Parenthood estimated that the bill would result in at least 200 at-risk clinics closing nationwide. That figure includes several clinics that have not made payroll within one to two months of not making payroll.

According to Planned Parenthood’s 2023-2024 annual report, the organization performed roughly 402,000 abortions in 2023 out of the nearly 1 million abortions in the U.S. that year. But it also provided approximately 2.2 million birth control consultations, 5.1 million sexually-transmitted infection tests and treatments, and 364,000 cancer screenings. 

A policy analysis from the anti-abortion Charlotte Lozier Institute estimated in April that there are more than 5,500 federally-qualified health centers, or FQHCs, and 3,300 rural health clinics that already provide comprehensive women’s healthcare subsidized by the federal government.

In 2023, FQHCs provided more than 3.4 million HIV tests, 1.9 million cervical cancer tests, and 1.6 million mammograms. They also provided nearly 1.7 million patients with contraceptives, but the Health and Human Services Department did not collect data on whether these centers provide abortions with non-federal funds.

Abortion-rights advocates argue that these health centers do not have the capacity to fill in the gaps in contraception coverage left behind by Planned Parenthood closures following the implementation of the reconciliation bill’s defunding provision.

The Guttmacher Institute, the research arm of Planned Parenthood, projected in an early-June policy brief that FQHCs would need to increase their capacity by 56% to provide contraceptive care equivalent to that of Planned Parenthood facilities should centers close. 

Another possibility: long-term deficits

An alternative explanation is that the measure might have violated the Byrd Rule’s prohibition on measures adding to federal deficits in the years beyond the budget window, which, in this case, was 10 years.

Although the defunding provision of the bill directly reduces spending by eliminating reimbursement for abortion providers, the Congressional Budget Office estimates that it will likely take into account that fewer low-income women will have access to birth control following Planned Parenthood closures. That, in turn, means more children will be born, resulting in higher Medicaid spending overall in the long term. 

The measure in the One Big Beautiful Bill Act that lists elective abortion providers as “prohibited entities” for Medicaid reimbursement is the only provision in the Medicaid section of the bill that adds to the deficit over the 10-year budgetary window, according to CBO scoring.

In May, the CBO estimated that the 10-year defunding effort in the House version of the reconciliation bill would have added $261 million to the deficit over the budget window from 2025 to 2034. 

However, the reduced one-year defunding in the Senate version of the bill that became law is only slated to add $52 million to the deficit, according to CBO estimates from June. 

For the one-year defund, CBO estimates included a reduction in spending by roughly $75 million in the first two years following the bill’s passage and a sharp increase in projected outlays in 2027 and the years following. 

In other words, it is possible or likely that the parliamentarian objected to including the provision in the reconciliation bill on the grounds that it would add to the deficits beyond the 10-year budget window.

Still, it’s unclear why that would have necessitated shortening the defunding period to just one year.

Long-term effects of defunding Planned Parenthood

Nevertheless, the GOP bill’s one-year defunding of Planned Parenthood will have significant ramifications in the next year, both for health centers and for the anti-abortion movement.

Alina Salganicoff, women’s health policy director at the think tank KFF, told the Washington Examiner that the policy will likely have disparate effects depending on the conditions in each state. 

“In some cases, there are state health departments, but in other cases, Planned Parenthoods are located in medically underserved areas or rural communities, and it’s not clear that patients who have been going there will have somewhere to go if they either have to close or greatly restrict services,” said Salangiocoff. 

Shortly after the bill was signed, Planned Parenthood filed a lawsuit against the provision, and a federal judge in Massachusetts issued a temporary injunction, pausing the defunding provision’s effects. The Department of Justice filed a motion to dismiss the lawsuit, but the litigation process is pending. 

In the meantime, however, anti-abortion advocates have hotly debated whether or not a one-year defunding effort can even be called a victory for the movement.

Brandt, the Live Action spokesman, told the Washington Examiner that it “should be an extremely high priority for every member of Congress who respects life and women’s healthcare that this defund gets extended.”