July 15, 2019

Federal appeals court declines to block HHS' Title X rule

Daily Briefing

    A federal appeals court on Thursday denied a request for an emergency stay on a recent ruling, allowing an HHS final rule that would bar providers and clinics that receive Title X family planning grants from providing or referring patients for abortion care.

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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." As such, the final rule prohibits 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. However, providers under the final rule can refer patients for emergency abortion care when necessary.

    The final rule also eliminates a federal policy that requires health care providers to offer abortion counseling to qualify for Title X family planning funds, and instead requires that Title X recipients refer pregnant patients for prenatal care.

    In addition, the final rule broadens the definition of "family planning" to include adoption, abstinence, infertility management, and natural family planning. Under the final rule, providers will be required to offer "a broad range of … methods and services," which do not all have to be medically approved.

    The final rule also seeks to address a coverage gap for U.S. residents whose employers do not offer health insurance coverage for contraceptives.

    The final rule also sets new standards for minors seeking care.

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

    In June, a three-judge panel for the 9th U.S. Circuit Court of Appeals ruled unanimously to allow the final rule to take effect as the administration challenges the preliminary injunctions. The panel in their ruling wrote that the final rule is "reasonable interpretation" of Title X and the administration likely will be successful in showing the final rule should be upheld.

    The panel also wrote the final rule supports the public interest. "Absent a stay, HHS will be forced to allow taxpayer dollars to be spent in a manner that it has concluded violates the law," the judges wrote.

    Appeals court denies emergency stay

    In response to the panel's ruling, a number of abortion rights advocates, including Planned Parenthood, as well as 20 U.S. states and the District of Columbia, filed a request for an emergency stay of the ruling.

    However, in a 7-4 vote an en banc panel of the 9th U.S. Circuit Court of Appeals upheld the June decision. California, Oregon, and Washington, requested the appeals court revisit its decision. The court is doing so on an expedited basis.

    Leana Wen, president of Planned Parenthood Federation of America, said the order was "devastating" to those who rely on Title X funds for health care, and said the rule allows the government to "censor our doctors and nurses from doing their jobs" (Stempel, Reuters, 7/11; Finnegan, FierceHealthcare, 7/11; Hellman, The Hill, 6/20).

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