While the revamp of the Title X program does not accomplish the full defunding of Planned Parenthood that Republicans have called for, it is a major step in that direction. | Scott Olson/Getty Images
The Trump administration issued a final rule on Friday that could effectively cut off tens of millions of federal family planning dollars to Planned Parenthood and steer some of that funding towards anti-abortion, faith-based care providers.
While the revamp of the Title X program does not accomplish the full defunding of Planned Parenthood that Republicans have called for, it is a major step in that direction, and marks another major policy win for social conservatives looking to prohibit access to abortion.Story Continued Below
Under the rule, clinics would still have to provide an array of contraceptive services but could partner or subcontract with groups that stress abstinence only or natural family planning. It would also bar Planned Parenthood and other health care providers that accept the funding from making any abortion referrals or performing abortions — regardless of the funding source — at the same facilities where they provide Title X services like birth control, mammograms and cancer screenings.
If not put on hold by a court injunction, the rule will go into effect 60 days after it is published in the federal register in the coming days.
Critics of the new policy, which will almost certainly end up in federal court, say it will amount to a “domestic gag rule” that prohibits health care providers from fully counseling their patients on their reproductive choices without government interference. Abortion rights groups have already sued the Trump administration over the way grant funding under the program is being distributed, arguing the criteria improperly stress abstinence over access to all FDA-approved forms of contraception.
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Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association was one of many abortion rights advocates to quickly raise the prospect of a lawsuit to stop the rule.
“This rule intentionally strikes at the heart of the patient-provider relationship, inserting political ideology into a family planning visit, which will frustrate and ultimately discourage patients from seeking the health care they need,” she said.
Washington Gov. Jay Inslee said he would explore challenges to the rule change, which “endangers tens of thousands of Washingtonians and millions of Americans.”
Conservatives hailed the new Title X guidance as a de facto “defunding” of Planned Parenthood because the organization receives between $50 million and $60 million per year through the $286 million program. The organization was already barred from using that federal funding to provide abortions. The bulk of Planned Parenthood’s government funding, however, comes from state Medicaid programs, which are unaffected by this rule.
“The Title X program was not intended to be a slush fund for abortion businesses like Planned Parenthood,” said Marjorie Dannenfelser, president of the anti-abortion group Susan B. Anthony List.
The Title X cuts could also hit other abortion providers that take Title X funds, but they would hit Planned Parenthood the hardest. The network of clinics serves 41 percent of the 4 million low-income people, most of them people of color younger than 30, who currently rely on Title X for their reproductive health care.
Unlike a Reagan-era version of the rule, health care providers in the program will be able to talk about abortion under the new guidance, but won’t be able to make a referral for the procedure. Supporters say the distinction means there is no “gag” on providers, but opponents say that makes little difference.
The rule, which arrived at the White House’s budget office for evaluation on Feb. 7, was sped through the review process. While the office typically takes more than six weeks to review a rule, there was political pressure to expedite the rule, according to two knowledgeable officials.
As a result, the White House instructed interested parties they had just a few days to submit comments. “All meetings and calls must take place by Friday [Feb. 15],” a White House staffer told the National Abortion Federation, a group opposing the policy.
House and Senate Democrats complained in a letter last week that the Department of Health and Human Services did not conduct a study of the rule’s economic and health impacts before approving it. They asked the agency to hold off on releasing it until that part of the process is complete. HHS did not respond to a request for comment on the rule’s approval process.
Similar Title X changes ordered by the Reagan administration were challenged all the way to the Supreme Court, which upheld the changes. However, they were never implemented because of repeated delays, and the Clinton administration later scrapped them.
Dan Diamond contributed to this report.
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