Under fire for much of its year history, Planned Parenthood has survived bouts of controversy, legislative attacks and even violence. The defunding effort comes on multiple fronts, including as part of a larger debate over repealing and replacing the Affordable Care Act ACA as well as in separate bills proposed in recent days.

Planned Parenthood began receiving federal funds to provide services to low-income women starting in , but since it has been barred from using public money for abortions. Given the number of patients that Planned Parenthood aids -- it operates health centers that provide services to 2.

Women's issues and healthcare have been key issues on the campaign trail. President of Planned Parenthood Action Fund Cecile Richards joined And unlike many private health care providers, Planned Parenthood accepts Medicaid patients and relies on private donations to make up the difference between the actual costs and the reimbursement rates.

Planned Parenthood did not return calls and emails asking for comment. The Government Accountability Office GAO estimates that , women would lose access and up to , would face reduced preventive care within a year if Congress blocked Medicaid patients from Planned Parenthood. The defunding has the potential to hit rural areas and the economically vulnerable hardest, said Friedrick-Karnik.

A Houston grand jury indicts two anti-abortion activists behind videos that purported to show Planned Parenthood employees discussing the sale of Planned Parenthood gets some Title X grants to provide safety-net family planning for millions of Americans. In 21 percent of the counties where the group serves as the safety-net clinic, no other equivalent exists in the area, according to the Guttmacher Institute, a research and policy organization devoted to reproductive health rights.

In many poor areas, the organization is the sole option for contraception and screenings for hypertension, diabetes and cancer. Republican Joni Ernst, a U. Senator from Iowa, however, disputes the notion that hundreds of thousands of women would be left without health services. State and county health departments, community health centers and hospitals should be able to fill the gaps that would be created without Planned Parenthood, according to text of a bill sponsored by Earnst.

The legislation, which Ernst introduced on Jan. Medicaid pays for the vast majority of family-planning services for low-income people, with the federal government picking up 90 percent of the tab and states covering the rest. The HHS rule came in reaction to bids by states including Texas to remove Planned Parenthood from their Medicaid programs. Still, unlike similar efforts in prior years, the odds of the current attempts to defund Planned Parenthood succeeding are considered good, given the Republican majority in Congress and possession of the White House.

As Ernst and Rep. Diane Black, R-Tennessee, wrote in an op-ed in the Washington Examiner in January: A week ahead of Ernst introducing her bill, the House voted to ban the use of any federal subsidies to pay for insurance plans that offer abortion services.

The measure intends to ensure that any replacement for Obamacare would include the same condition. Both the House and Senate have approved blueprints of reconciliation packages calling for a repeal of the ACA.

That said, Republicans have yet to agree on how exactly to replace the ACA, a detail that offers a glimmer of hope for those looking to keep the law -- and funding to Planned Parenthood -- going.

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After some encouragement from comedian John Oliver, thousands of people have donated to Planned Parenthood in Vice President-elect Mike Pence's n The moves by Ernst and other Republicans come in the face of vocal public opposition.

The turnout also overshadowed the tens of thousands who participated in the annual March for Life that followed in late January. Furthering the point, a Quinnipac poll released Jan. That sentiment was expressed in a surge of donations to Planned Parenthood in the wake of the November presidential election.

If efforts to halt federal funding to Planned Parenthood succeed, the impact would be felt differently in individual states.

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