Defunding Planned Parenthood has been a goal of the anti-abortion movement for decades. Republicans thought they could make the group ineligible to provide care to Medicaid patients at part of their bill — which did not pass — to rewrite the Affordable Care Act in 2017.

On his first day in office, California Democratic Gov. Gavin Newsom called for a state-based mandate, which would require all Californians to have health coverage. The legislature would have to approve it, which isn’t guaranteed even with a Democratic majority because the mandate was one of the least popular provisions of the Affordable Care Act.

She said the easiest way to change the trend would be for more states to expand Medicaid under the health law. Fourteen states have yet to do so. Though the expansion largely affects adults, as parents enroll, their children are likely to follow.