Conservative groups are pressing congressional Republicans to renew a federal ban on Medicaid funding for Planned Parenthood after a one-year restriction expired Friday, arguing the lapse reverses what they had hailed as one of the movement's biggest policy victories since the Supreme Court overturned Roe v. Wade.
The provision, enacted last year as part of Republicans' budget reconciliation law, barred Medicaid reimbursements to Planned Parenthood and other large abortion providers for non-abortion health services.
Congress did not extend the measure before lawmakers left Washington for the Independence Day recess, allowing the restriction to expire.
Sen. Josh Hawley, R-Mo., said he had doubted Republican leaders would have another opportunity to revive the provision through the budget reconciliation process.
"I've thought all along that a third reconciliation bill is highly unlikely for any number of reasons. When [leadership] said, 'Well, we'll do that later,' my point was always: I don't know that there'll be a later," Hawley told Politico.
Hawley called the decision to omit another Planned Parenthood funding restriction from the Republicans' immigration-focused reconciliation package approved in June "a huge missed opportunity."
"The fact that congressional leaders decided not to defund them as part of the last reconciliation bill is just beyond me," he said.
"That was really taking the pro-life movement and pro-life voters for granted, because you're depending on those voters to turn out and vote for you in November."
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called on Republicans to restore the policy when Congress returns.
"Defunding Big Abortion is now the default expectation of the pro-life movement," Dannenfelser said in a statement.
"When they return to D.C., Republicans must do all they can through reconciliation to once again block taxpayer dollars from Planned Parenthood and abortion businesses," she said.
The House Freedom Caucus also urged Republican leaders to pursue another reconciliation bill that would again prohibit federal Medicaid funding for abortion providers, saying voters expect the GOP to deliver on campaign promises after winning control of Washington.
Although conservatives fell short of extending the nationwide restriction, many anti-abortion advocates say a recent Supreme Court decision has shifted the fight to the states.
In Medina v. Planned Parenthood South Atlantic, the court ruled that states may exclude Planned Parenthood from their Medicaid programs and that Medicaid beneficiaries cannot sue in federal court to challenge those decisions.
The ruling is expected to make it easier for Republican-led states to block the organization from participating in Medicaid.
Several states already prohibit Planned Parenthood from participating in their Medicaid programs, while others are expected to pursue similar restrictions following the ruling.
Planned Parenthood and abortion-rights advocates criticized the expiration effort and welcomed the restoration of Medicaid reimbursements, saying the one-year funding restriction forced clinic closures and reduced access to preventive care, including cancer screenings, contraception, and testing for sexually transmitted infections.
The organization has said dozens of health centers closed or consolidated while the restriction was in effect.
The Medicaid provision was one of Republicans' most significant anti-abortion achievements after President Donald Trump signed last year's reconciliation package into law.
Because it was enacted through the budget reconciliation process, however, the funding restriction was limited to one year.
Planned Parenthood said the funding restriction disrupted access to routine health care, particularly in rural and medically underserved communities.
Nora Walsh-DeVries, the organization's vice president of political and legislative affairs, told NPR that the yearlong ban caused "irreparable damage" to its network, leading to fewer patient visits and the closure of clinics, many of them in areas with limited access to health care.
"The impact of this defunding did not result in less abortion care," Walsh-DeVries told Politico. "It just resulted in less people being healthy, less people being able to get care and access in a place that they want to get care and access."
She said the closures reduced access to services such as cancer screenings, contraception, and pelvic exams, particularly in states that did not provide funding to offset the loss of federal Medicaid reimbursements.
With the federal ban now expired, anti-abortion groups say their immediate focus will be on persuading Congress to revive the restriction while encouraging Republican-led states to use their newly affirmed authority to remove Planned Parenthood from their Medicaid programs.