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May 22, 2018

Trump to announce proposal to restrict Title X family planning funds

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    President Trump Tuesday evening is expected to unveil a proposed rule to change federal requirements for health care providers that receive Title X family planning grants.  

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    Proposed rule details

    According to the Washington Post's "To Your Health," administration officials briefed antiabortion-rights groups on the proposed rule during a conference call on Friday. Officials declined to provide the final text of the proposed rule, but said HHS on Thursday sent the proposed rule to the White House Office of Management and Budget for an interagency review. Two administration officials said President Trump intends to officially unveil the proposed rule on Tuesday during an event held by the antiabortion-rights group Susan B. Anthony List. According to ABC17 News, Trump's speech is expected to begin at 7:30 p.m. ET.

    The proposed rule would eliminate a federal policy that requires health care providers to offer abortion counseling to qualify for Title X family planning funds, The Hill reports. A senior White House official said the Trump administration chose to make it optional for health care providers that receive Title X funds to offer abortion counseling, instead of prohibiting such providers from offering abortion counseling, to avoid potential litigation.

    In addition, people briefed on the proposed rule said it would require minors who seek family planning services at Title X providers to have parental consent in most cases, "To Your Health" reports.

    Further, the proposed rule would prohibit the federal government from dispersing Title X family planning funds to health care providers that offer abortions and abortion referrals in the same locations that they offer family planning services, "To Your Health" reports.

    According to Politico's "Pulse," the administration Friday night said the "proposed rule would not cut funds from the Title X program." It added, "Instead, it would ensure that taxpayers do not indirectly fund abortions."

    Officials have said it would take several months before the proposed rule could take effect, because the proposed rule must go through the interagency review process.


    According to "To Your Health," the proposed rule would make providers such as Planned Parenthood and other women's health centers ineligible for Title X grants. Under current regulations, such providers receive Title X funds to provide basic health services—such as contraceptives, pregnancy tests, and screenings for sexually transmitted infections—but also provide abortion services and referrals. Current regulations prohibit the use of federal funds for abortion services, but do not bar providers from using nonfederal funds for such services or make providers who offer abortion services ineligible for Title X grants.

    According to "To Your Health," the proposed rule could result in Planned Parenthood—which provides services to 41% of the four million people who receive care under Title X funds—losing up to $60 million a year.

    Similarly, Susan Buchanan, CEO of the Boulder Valley Women's Health Center, said Title X grants represent about 20%—or $550,000—of the health center's budget. Buchanan said the proposed rule would place the health center "in the position of having to make a Hobbesian choice" between the 10% of the health center's patients who receive abortions and the remainder of patients who do not receive such services.

    According to the New York Times, the majority of U.S. residents who could be affected by the proposed rule would be those who are uninsured, particularly in states where officials have not expanded Medicaid under the Affordable Care Act.


    Several antiabortion-rights advocates and groups applauded the news.

    The Susan B. Anthony List in a statement said, "This is a major victory which will energize the grassroots as we head into the critical midterm elections."

    Separately, Jeanne Mancini, president of March for Life, said the proposed rule would "redirect[t]" Title X family planning funds "to comprehensive family health and planning centers that don't perform abortions."

    Tony Perkins, president of the Family Research Council, said, "Planned Parenthood and other abortion centers will now have to choose between dropping their abortion services from any location that gets Title X dollars and moving those abortion operations off-site." He added, "Either way, this will loosen the group's hold on tens of millions of tax dollars."

    Other groups criticized news of the proposed rule.

    Planned Parenthood officials on Friday said the proposed rule is an attack on a woman's right to have an abortion that interferes with a woman's access to basic health care services. Dawn Laguens, Planned Parenthood's executive vice president, said, "It's completely outrageous that a small group of people's ideological views are being pressed through these government agencies onto women's health care across the country." Laguens said, "The inability to refer someone who might be in a very serious medical condition for abortion care is really unethical in our view."

    Kashif Syed, a senior analyst at the Planned Parenthood Federation of America, said, "Blocking doctors from telling patients where they can get specific health services in this country is the very definition of a gag rule."

    Jenn Conti, a fellow with Physicians for Reproductive Health, said "This 'gag rule' is not only unconscionable, but it undermines medical ethics by forcing health care professionals to withhold accurate and timely medical information from patients." She continued, "If I can't mention the word 'abortion,' then I am not providing my pregnant patients who want to know all of their options with complete, accurate, unbiased medical information."

    Groups threaten legal action

    According to "To Your Health," Washington Gov. Jay Inslee (D) and a number of women's health groups have announced plans to file lawsuits seeking to block the proposed rule.

    However, David Christensen, vice president of government affairs for the Family Research Council, expressed confidence that the proposed rule would survive a legal dispute. "Our understanding of the proposed regulation that the administration will put forward ... is entirely consistent with [a] Supreme Court precedent in separating abortion from the Title X family planning program," he said (Rampton, Reuters, 5/18; Hellmann/Bowden, The Hill, 5/18; Eunjung Cha et al., "To Your Health," Washington Post, 5/18; Hirschfeld Davis, New York Times, 5/18; Haberkorn, Politico, 5/18; Diamond, "Pulse," Politico, 5/21; ABC17 News, 5/22).

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