August 16, 2019

Planned Parenthood on Wednesday announced it will formally withdraw from the Title X federal family planning program by Aug. 19 unless a federal court blocks the Trump administration's rule, which bars clinics that receive Title X funds from providing or referring patients to non-emergency abortion care, AP/Modern Healthcare reports.

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Background

HHS in February issued a final rule that requires recipients of Title X family planning funds "to separate their Title X project—physically and financially—from any abortion activities." However, providers under the final rule can refer patients for emergency abortion care when necessary.

The final rule originally was scheduled to take effect May 3, but federal judges in California, Oregon, and Washington issued preliminary injunctions blocking the final rule. The Trump administration appealed each of those injunctions.

In a 7-4 vote issued last month month, an en banc panel of the 9th U.S. Circuit Court of Appeals upheld a ruling that allowed the final rule to take effect. California, Oregon, and Washington have requested the appeals court revisit its decision, and the court is doing so on an expedited basis.

While the court reviews the case, HHS is moving forward with plans to implement the final rule.

HHS in guidance released earlier this month stated that affected providers must submit written assurance to HHS by Aug. 19 that they do not provide abortion care or include abortion care as a family planning method. In addition, affected providers must submit an "action plan" detailing how they will comply with the final rule, according to a separate HHS notice.

The notice also stated that affected providers must be in compliance with all effective portions of the final rule by Sept. 18. However, the notice did not include detailed information on how affected providers should interpret the final rule.

Planned Parenthood to exit Title X

Planned Parenthood in a notice to the 9th U.S. Circuit Court of Appeals in San Francisco on Wednesday said the organization will formally exit the Title X program by Monday, Aug. 19, unless the court blocks the Title X funding rule, AP/Modern Healthcare reports.

Planned Parenthood in the letter said it had temporarily stopped using Title X funding while its challenge to the new rule went through the courts.

However, Planned Parenthood said HHS' recent requirement that all program participants on Aug. 19 sign a pledge to comply with the rule will "forc[e]" the organization "to withdraw" from the program by close of business on Monday unless the court intervenes.

Planned Parenthood said it will remain open as it continues to contest the rule.

Implications

Planned Parenthood's exit from Title X would be a major change for the organization, which has participated in Title X since the program's creation in the early 1970s, NPR reports. According to Vox, Planned Parenthood treats 40% of the four million Title X patients.

Planned Parenthood spokesperson Erica Sackin said the impact of the organization's withdrawal from the program will vary by state. Some states have said they will intervene to help, according to AP/Modern Healthcare.  "Planned Parenthood health centers are doing everything we can to make sure patients can still get care," without Title X funding, Sackin said but added that "it would be a mistake to think there won't be changes."

Meanwhile, HHS in its guidance from last week wrote, "To the extent that Planned Parenthood claims that it must make burdensome changes to comply with the Final Rule, it is actually choosing to place a higher priority on the ability to refer for abortion instead of continuing to receive federal funds to provide a broad range of acceptable and effective family planning methods and services to clients in need of these services" (Diamond, "Pulse," Politico, 8/15; AP/Modern Healthcare, 8/14; McCammon, NPR, 8/14; Cha, Washington Post, 8/14; North, Vox, 8/14).

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