PHOENIX (AP) — From the U.S. Capitol and the White House to far-flung battlegrounds in Arizona, Iowa and elsewhere, it's been a dramatic fortnight in the debate over access to abortion and birth control. Foes of abortion celebrated a series of advances and claimed new momentum, as abortion rights supporters mounted protests to try to blunt it.
Planned Parenthood, the anti-abortion movement's prime target, called it "the world's worst week for women's health."
Among the developments in recent days:
—House Republicans passed a health care bill that would halt most federal funding to Planned Parenthood for a year and expand restrictions on private insurance coverage of abortion.
—President Donald Trump issued an executive order on religious liberty that will likely make it easier for employers to drop coverage of contraceptives from their health care plans. The secretary of Health and Human Services, conservative physician Tom Price, said he would act swiftly "to safeguard the deeply held religious beliefs of Americans who provide health insurance to their employees."
—Trump appointed a prominent anti-abortion activist, Charmaine Yoest, to serve at HHS as assistant secretary of public affairs. Yoest, as president of Americans United for Life from 2008-2016, played a key role in the enactment of scores of state laws restricting abortion access. Her appointment was lauded by Vice President Mike Pence, who declared in a speech, "For the first time in a long time, America has an administration that's filled top to bottom with people who stand without apology for life."
—Iowa Gov. Terry Branstad signed a bill banning most abortions after 20 weeks of pregnancy. A similar bill has reached the governor's desk in Tennessee; a third such measure is pending in Missouri. Similar laws are in effect in at least a dozen other states, and Trump has promised to sign a federal 20-week ban if it can survive a potentially difficult path through Congress.
—Republican lawmakers in Arizona and Iowa took steps to join a growing list of states that have acted to curtail public funding for Planned Parenthood, which is the leading provider of abortions in the U.S. but also provides a range of other health services that would be affected by the funding cuts.
In Iowa, the GOP plan is to create a state-run family planning program that excludes abortion-providing organizations such as Planned Parenthood. Iowa would give up federal Medicaid money and instead spend about $3.1 million in state funds.
In Arizona, GOP lawmakers have included a provision in the state budget that diverts about $2 million in federal funding away from Planned Parenthood. Bryan Howard, president of Planned Parenthood Arizona, says the five clinics now in jeopardy serve many uninsured patients and could close if they lose the money. He said those funds have helped serve 20,000 people with contraception, cancer screenings and other non-abortion treatments.
Blanca Chico, a 39-year-old from Phoenix, said that as an uninsured patient, Planned Parenthood Arizona has given her health services at a reduced cost that she can afford. Chico, a mother of four, said she was able to get an intrauterine device for less than half its usual price because her clinic only made her pay what she was able to.
"They are helping a lot of people, because not everyone is able to pay for a consultation or all of the medication," Chico said. "And they only ask for a donation for the services."
Chico, who also has used the clinic for annual checkups and pap tests, said the proposed cuts would force her to find another provider.
"It's very complicated finding a place that is low cost and that I feel confident I can get the services," Chico said. "I have felt really satisfied with the clinic ... they have always helped me with everything."
Several other states where Republicans hold power have sought in previous years to curtail funding to Planned Parenthood.
After Texas cut off state funding to abortion providers in 2011, 82 family planning centers closed in the state — a third of which were Planned Parenthood affiliates. A state report later found that 30,000 fewer women were served through a Texas women's health program after the changes. Planned Parenthood now has 35 clinics in Texas and served more than 126,000 individual patients last year, including those seeking abortions.
Under the GOP-backed health care bill that cleared the House last week, people who rely on Medicaid would be unable to get subsidized preventive care at Planned Parenthood health centers — including birth control, cancer screenings and testing for sexually transmitted diseases. Estimates by the Congressional Budget Office suggest that defunding Planned Parenthood would save roughly $200 million in federal spending while reducing health care for perhaps 390,000 people.
The bill's fate is uncertain, with senators of both parties saying the House version will not survive in its current form. Activists on both sides of the abortion debate will be engaged in a heated lobbying battle over whether the Planned Parenthood defunding is maintained or scrapped in the revised version.
"We urge the Senate to keep these nonnegotiable provisions and quickly advance this bill to the president's desk," said anti-abortion leader Marjorie Dannenfelser, president of the Susan B. Anthony List. Dannenfelser and other leading anti-abortion activists threw their support behind Trump in last year's election in part because of his pledge to sign a defunding measure.
Planned Parenthood and its allies have been organizing protests at the offices of Republican members of Congress who voted for the new health care bill.
"This is the worst bill for women's health in a generation," said Planned Parenthood's president, Cecile Richards. "It makes it harder to prevent unintended pregnancy, harder to have a healthy pregnancy, and harder to raise a family."
A few states where Democrats have at least a share of power have taken steps to ensure continued funding of Planned Parenthood and to protect access to abortion and contraception. In Montana, Democratic Gov. Steve Bullock vetoed a bill last week that would have outlawed most abortions after 20 weeks of pregnancy. Pennsylvania Gov. Tom Wolf has vowed to veto a similar bill if it reaches his desk, as well as a proposal to ban a commonly used second-trimester abortion procedure.
Overall, however, the anti-abortion camp says momentum is on its side. As evidence, they cite Trump's appointment of federal judges who are widely viewed as receptive to further restrictions on abortion.
"Folks are excited that we've got a different administration, so there's a sense of optimism," said Melanie Israel of the conservative Heritage Foundation. "Everyone is curious to see what's going to happen."
David Crary reported from New York. Associated Press writer Paul Weber in Austin, Texas, also contributed to this report.