Over the past year, President Donald Trump and his Republican allies have failed in several efforts to defund Planned Parenthood.
As we've noted, federal dollars do not actually fund abortions. A longstanding provision known as the Hyde Amendment excludes Planned Parenthood and other medical providers from using federal dollars to pay for most abortion services, except in instances of rape, incest or when a woman's life is in danger.
Abortion opponents argue that even these types of federal payments mean that the government is indirectly supporting abortion, so they have pursued various legal and regulatory approaches to shut down the federal funding streams that currently support organizations like Planned Parenthood.
Indeed, estimates show that the organization receives about 40 percent of its funding from the government. Planned Parenthood receives more than $500 million in combined state and federal government funds.
Planned Parenthood gets most of its funding through Medicaid reimbursements and from Title X, a Health and Human Services grant program that funds comprehensive family planning services.
Those who support defunding Planned Parenthood cheered when Congress and Trump in 2017 effectively overturned an Obama administration rule that had been written to prevent state and local governments from pulling federal funding from Planned Parenthood and other clinics.
But Kinsey Hasstedt, a senior policy manager with the Guttmacher Institute, a reproductive-issues research organization, said this move was more symbolic than something with a solid legal effect. The question will play out in the courts.
"In repealing that regulation, Congress and President Trump surely sought to send a message inviting state efforts to exclude Planned Parenthood and other like providers from Title X," she said. "That doesn't mean states actually have the legal right to do so."
Meanwhile, other developments in the past year have been less favorable to those advocating for defunding.
In the Republican effort to "repeal and replace" the Affordable Care Act, provisions to effectively defund Planned Parenthood were typically included, notably in the "skinny repeal" bill that came close to passing the Senate. But in the end, none of the bills passed.
In the omnibus spending bill that Congress passed and Trump signed in March 2018, defunding supporters were unable to attach a provision to curb federal funding for Planned Parenthood and groups like it.
Then, in August, the Senate voted down an amendment to a spending bill sponsored by Sen. Rand Paul, R-Ky., that would have shut down federal funding for Planned Parenthood. The amendment failed, 45-48, with all Democrats voting against, joined by Republicans Susan Collins of Maine and Lisa Murkowski of Alaska.
Finally, in December, the Supreme Court decided not to hear a pair of cases related to state efforts designed to keep groups like Planned Parenthood from receiving federal funding. In the cases at issue, states argued against the rights of individuals to legally challenge state moves to curb federal funding, including Medicaid dollars, to Planned Parenthood.
In the absence of a high court ruling, lower court rulings stand, and they mostly sided with the rights of individuals to challenge state actions. So the Supreme Court's non-decision was seen as a victory for the Planned Parenthood side.
Unlike the other developments listed here, the court's decision was outside the purview of the Trump administration, but it could have had a substantial impact, said Sara Rosenbaum, a health law and policy professor at George Washington University's Milken Institute School of Public Health.
"If the court had agreed to hear their appeals and had ruled in their favor, my conservative estimate is that half the states would have eliminated Planned Parenthood as a qualified provider" for federal funds, she said.
Now that Democrats have taken control of the U.S. House of Representatives, defunding Planned Parenthood through Congress is even more unlikely.
For now, the administration hopes to defund Planned Parenthood through a regulatory process.
One move involves proposed regulations for Title X funding that would, among other things, block funds for Planned Parenthood and other providers that offer abortion services.
"Because Planned Parenthood serves so many Title X family planning patients -- about 41 percent of the 4 million who receive Title X services -- if Title X becomes restricted only to providers who do not offer abortions, it would cut about $50 million in funding from Planned Parenthood, and that would be real progress towards de-funding them," said Gretchen E. Ely, an associate professor in the University at Buffalo's School of Social Work.
Another effort involves proposed administration regulations to two separate monthly bills to be sent to people who bought Affordable Care Act marketplace plans that include abortion coverage -- one bill for the bulk of their health coverage, and a second bill exclusively for abortion services.
That adds extra hassle for people who use ACA plans to get services at Planned Parenthood, offering an indirect avenue to de-fund the group and reduce coverage of abortion generally, Ely said.
If either regulation is finalized, opponents are expected to challenge them in court.
"From our perspective, it seems that the administration has done everything it could" to defund Planned Parenthood, said David N. O'Steen, executive director of National Right to Life, an anti-abortion group.
The bottom line is that the Trump administration's chances of carrying through on this promise are smaller now that Democrats control the U.S. House of Representatives. If the regulatory proposals are finalized, we'll reconsider, but for now, we rate this promise Stalled.