House Republicans last week passed a proposal to end federal funding for Planned Parenthood for one year. Though the measure is expected to be vetoed by Barack Obama, this is the first time a bill defunding Planned Parenthood has been sent to the president’s desk in over 40 years — a sobering reminder of lawmakers’ determination to weaken an organization serving millions of women, many of whom have few other options for health care.

Planned Parenthood has been the focus of an unrelenting offensive since the release last summer of undercover recordings purporting to depict illegal for-profit fetal tissue sales by agency officials. Though the videos have been debunked and multiple investigations have uncovered no wrongdoing, the controversy continues.

Six states have cut off funding to Planned Parenthood. The baseless accusations against the nonprofit have been a staple of the Republican presidential debates. And the Senate voted Dec. 3 to defund Planned Parenthood, with the House following suit Jan. 6.

The bill that’s headed to the president would strip Planned Parenthood of about $450 million in federal funding for its women’s health care programs (excluding abortion, which already gets no federal appropriations). The nation’s 9,200 community health centers would receive an extra $235 million so they could fill the gap in care. Experts say, though, that picking up the slack won’t be so easy.

Planned Parenthood clinics and community health centers both treat low-income patients, including people with no insurance and people on Medicaid. Planned Parenthood serves a bigger share of women who need publicly funded birth control than any other so-called safety net caregiver. But women’s health services are just part of the mission at community clinics, which are often their patients’ only source for mental health and dental care and treatment of chronic conditions like heart disease and diabetes.

Even with more federal funding, scholars and health care providers say, these facilities don’t employ enough physicians to meet the needs of a massive influx of new patients — especially when an ongoing ob-gyn shortage is taken into account.

If Planned Parenthood were gutted, then, 390,000 women who are uninsured or who receive Medicaid wouldn’t have a place to get affordable birth control, breast and cervical cancer screenings and other basic care, federal analysts estimate. At least community health centers are a plausible alternative to Planned Parenthood. The website GetYourCare.org, launched by an alliance of anti-abortion groups to “show women they have more choices besides Planned Parenthood,” directs women seeking low-cost care not only to public health centers but also to facilities that aren’t open to people from the larger community — like county jails, nursing homes and school nurse’s offices.

In Portland, the website’s suggestions include Health Care for the Homeless (which closed in 2014, when Portland Community Health Center took over the program) and a clinic for homeless young people (which serves a specific population under the age of 21).

Augusta-area women are advised to turn to the Migrant Voucher and Mobile Medical Van (which serves only farmworkers and people who’ve earned money by doing farmwork in the past two years).

In public office and in the private sector, people are pushing for the elimination of Planned Parenthood by arguing that its services aren’t needed. The recent House vote to defund the organization may be symbolic, but it’s also a significant victory in the battle over who has a voice in a woman’s health care decisions. And those on the side of autonomy and personal agency can’t afford to keep quiet.