A federal appeals court on Friday again allowed a final rule that bars clinics that receive Title X funding from providing abortions or referring patients to non-emergency abortion care to take effect, prompting Planned Parenthood on Monday to announce plans to officially exit the program.
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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, 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 requested the appeals court revisit its decision, and the court agreed to do so on an expedited basis.
HHS in guidance released earlier this month stated that affected providers must be in compliance with all effective portions of the final rule by Sept. 18, and 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.
Appeals court again declines to block final rule
The 9th U.S. Circuit Court of Appeals on Friday again ruled that the final rule may take effect while the administration appeals district court rulings against the regulation. According to The Hill, oral arguments in the appeals are scheduled to begin next month.
Planned Parenthood leaves Title X program
As a result of the ruling, Planned Parenthood on Monday announced it will leave the Title X program, Politico reports.
Planned Parenthood in a notice filed with the appeals court last week said HHS' recent requirement that all program participants on Aug. 19 sign a pledge to comply with the rule would "forc[e]" the organization "to withdraw" from the program unless the court intervened.
Alexis McGill Johnson, acting president and CEO of Planned Parenthood, on Monday said, "We will not be bullied into withholding abortion information from our patients."
Planned Parenthood's exit from Title X marks a major change for the organization, which has participated in Title X since the program's creation in the early 1970s. The organization treats about 40% of the four million Title X patients.
Planned Parenthood spokesperson Erica Sackin last week said the impact of the organization's withdrawal from the program will vary by state. "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."
McGill Johnson on Monday said the group's exit from Title X could mean that some low-income women in rural areas might face difficulty accessing affordable contraception options. "For too many people struggling to make ends meet, it may be that they may go without care," she said.
Some states have said they will intervene to help with the funding loss. According to Politico, Planned Parenthood received about $60 million annually in Title X funds.
McGill Johnson said Planned Parenthood is "identifying all strategies … to try to identify the best strategies in order to make sure [the organization] can sustain and keep [its] doors open for [its] patients no matter what." She added that Planned Parenthood will continue to fight the final rule in court (Axelrod, The Hill, 8/16; Associated Press, 8/16; Ollstein, Politico, 8/19; Smith, CBS News, 8/19; Sullivan, CNN, 8/19).