The Trump administration issued a rule Friday barring groups that provide abortions or abortion referrals from participating in the $286 million federal family planning program, a long-expected move that would direct money away from Planned Parenthood and toward faith-based providers.
The regulation, called “The Protect Life Rule,” shores up Title X of 1970’s Public Health Service Act, prohibiting the Department of Health and Human Services from funding family planning projects in which abortion is part of the family planning process. President Ronald Reagan first issued the rule, which was upheld by the Supreme Court in 1991.
President Bill Clinton rescinded the policy through an executive order. No president has since sought to re-issue the rule.
Anti-abortion groups cheered the decision.
“It is absolutely appropriate that the new Title X regulations take into account the difference between abortion and health care,” said Jeanne Mancini, March for Life president.
However, critics of the rule said it amounts to little more than placing a gag order on physicians and health professionals who will be unable to frankly and widely discuss health care options with women.
“This rule compromises the oath that I took to serve patients and help them with making the best decision for their own health,” said Dr. Leana Wen, president of Planned Parenthood Federation of America. “Patients expect their doctors to speak honestly with them, to answer their questions, to help them in their time of need.”
The final rule had widely been expected from HHS Secretary Alex M. Azar after the department issued a 300-page draft of the rule last year that called for organizations receiving Title X funding to have a “physical and financial separation” between abortion services and birth control or family-planning programs. Federal law already prevents federal funds from being used to pay for abortions.
Title X, enacted in 1970 under President Richard Nixon, has provided access for low-income or underinsured individuals to a range of services, such as contraception, sexual education, cancer screening, and referrals to health services for pregnancy.
While the text of Title X stipulates that funds may go only to clinics where “abortion is not a method of family planning,” the practice had been that so long as money did not fund abortions but rather health care services at clinics that happened to also provide abortions, the spirit of the law was met.
But in 1988, the Reagan administration changed that, issuing rules specifically prohibiting employees in federally funded family planning facilities from counseling patients on abortion. In other words, if organizations wanted federal money, they could have no part in performing or even referring people to get abortions.
Planned Parenthood and the city and state of New York challenged the ruling in court. But in 1991, in a 5-4 opinion, Chief Justice William Rehnquist wrote that the “government is not denying a benefit to anyone, but is instead simply insisting that public funds be spent for the purposes for which they were authorized.”
While New York Attorney General Letitia James promised legal action, many abortion opponents cheered the decision from an administration that has strongly aligned its fortunes to theirs.
“The radicalized abortion industry as seen in blatant support for virtual infanticide in late-term abortions must be defunded in every program,” said Students for Life of America President Krista Hawkins. “This is the kind of policy change that millennials, the nation’s largest voting bloc, support. Health care dollars should fund real, full-service medical care, not abortion vendors.”
About 4,000 clinics received Title X funding in 2017, according to the Henry J. Kaiser Family Foundation. The organization predicts there would be a shrinking of eligible clinics. It is estimated that 25 percent of Title X funds go to Planned Parenthood.
Rep. Elijah E. Cummings, chairman of the House Oversight and Reform Committee, said he was “deeply disappointed” by the Trump administration for going ahead with the rule change and raised questions about the integrity of the rule-making process.
“The administration is ignoring the significant health and economic impacts its actions will have on millions of Americans who rely on the Title X program,” Mr. Cummings said.
In a statement to the press, HHS clarified a range of implications because of the reassertion of Title X, including the accessibility of birth control for low-income individuals “if they are unable to obtain employer-sponsored insurance coverage for certain contraceptive services due to their employer’s religious beliefs or moral convictions and the limitations of their own financial resources.”