“I, for one, don’t think Planned Parenthood ought to get a penny, though. And that’s the difference, because they’re not actually doing women’s health issues. They are involved in something way different than that.”

— Former Florida governor Jeb Bush (R), town hall in Englewood, Colo., Aug. 25, 2015

Jeb Bush, who cut off state funding for Planned Parenthood as Florida governor, is a part of a chorus of Republicans calling for the federal government to pull funding for the group. He doubled down on his attack of Planned Parenthood during a recent town hall event, and his comments went viral on social media almost immediately.

How accurate is his description of “women’s health issues” offered by Planned Parenthood and supported through federal funds?

The Facts

Bush came under fire earlier in August for his comments suggesting that women’s health services are overfunded (“I’m not sure we need half a billion dollars for women’s health issues”). He subsequently clarified the statement to say that he misspoke, and that his comments were limited to the “hard-to-fathom $500 million in federal funding that goes to Planned Parenthood.”

The constituent question that prompted his Aug. 25 statement related to his earlier comments and went, in part: “My question for you today is in light of a recent quote with regard to funding levels for women in health care. I’m wondering about your position on increased funding for the women’s programs within the Department of Veteran Affairs.”

Bush answered that funding should be given to expand women’s health services through community-based organizations. He then said that Planned Parenthood should not be given any federal funding because the organization is not “actually doing women’s health issues.”

As we recently wrote, it is difficult to accurately discern how much of Planned Parenthood’s services comprise abortions. (The organization earned Three Pinocchios for its claim that abortions are just 3 percent of its services.) Planned Parenthood has a broad definition for “services” (“discrete clinical interaction”). Regardless, Planned Parenthood clearly provides an array of women’s health services, including Pap tests, female sterilization, contraception and urinary tract infection treatments.

Planned Parenthood received $528.4 million in state and federal funding in 2013. The majority of federal funding that Planned Parenthood health centers receive are through Medicaid reimbursements or grants through the federal family planning program, Title X.

A long-standing legal restriction bans federal funds from paying for any elective abortions, which are for pregnancies that are not caused by rape, incest or that threaten the mother’s health. So even if Bush opposes Planned Parenthood’s abortion practices, pulling federal money would not necessarily affect how Planned Parenthood’s abortions are funded.

Hillary Clinton’s campaign criticized his statement via Twitter after the town hall, citing statistics from Planned Parenthood’s annual report. The Bush campaign’s response linked to an article from a right-leaning Web site showing a map of health clinics that could absorb Planned Parenthood’s services if the organization no longer receives federal funding. He also called Planned Parenthood’s “treatment of unborn” as “horrifying,” referring to abortions and the recent controversy over the fetal tissue donations, exposed in a series of covert videos filmed by an anti-abortion group.

A March 2013 George Washington University study found that virtually all community health centers provide family planning services, at least at the most basic level. Researchers also found that centers varied widely on the scope of care and approach to how family planning and women’s health services were provided. Most health centers have referral arrangements with other hospitals and organizations, including Planned Parenthood, for women’s health and family planning services.

Planned Parenthood clinics serve a disproportionate share of uninsured women who rely on publicly funded family planning centers, according to the Guttmacher Institute, which supports abortion rights. Planned Parenthood comprises 10 percent of publicly funded family planning centers, but serves over one-third of people who rely on these safety net health centers. (Read our fact check for more on this topic.)

Whether all of Planned Parenthood’s patients can be absorbed by alternative care providers and community health centers remains in question. Those pushing for stopping federal funds for the organization say there are plenty of community health centers that can fill the gap, with increased funding set to be made available by 2019 through the Affordable Care Act. But others — including some Republicans in Congress — have questioned whether that truly is the case, especially for women in remote areas and considering the shortage of providers.

A 2012 case study by GWU researchers found that after Texas stopped funding abortion providers, including Planned Parenthood, the average women’s health service caseload for community clinics increased by 81 percent. The study had found that some clinics would have to double to quintuple their caseloads to fully absorb patients that were served by Planned Parenthood in their areas in 2011. Proponents of Planned Parenthood point to this study to show that Planned Parenthood is a dominant source of women’s health service in some areas. Opponents point to it to show the number of abortions and unplanned births dropped as a result.

“Gov. Bush is a strong advocate for women’s health care, many of the basics of women’s health care are not provided by Planned Parenthood,” a campaign spokeswoman said, declining to be identified. “Planned Parenthood is, however, the largest abortion provider in the country and their disturbing practices that have been publicized recently have nothing to do with women’s health. As those videos show, Planned Parenthood needs to be investigated, not subsidized. Gov. Bush believes federal money should go to the many organizations that are promoting women’s health care first, not promoting abortion.”

The Pinocchio Test

We recognize that Bush spoke off-the-cuff during the town hall event. But his statement, that Planned Parenthood is “not actually doing women’s health issues,” is patently incorrect. (It would have made a difference if he had said Planned Parenthood “was not only doing women’s health issues,” in an effort to focus on the organization’s abortion services.)

If he is making a point that abortions (and related, fetal tissue donation) are the majority of services Planned Parenthood provides, that is a problematic and unsupported claim. The Twitter response by Bush’s campaign appeared to make a point that federal funding from Planned Parenthood should be pulled because community organizations can absorb Planned Parenthood’s services. That is one of the main arguments that are made for defunding Planned Parenthood, but there are data that both support and refute that point.

If it is his goal to make that point, Bush needs to refine his answer to accurately reflect underlying data.

Four Pinocchios

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