Earlier this year, the Trump administration issued a new abortion rule that bars healthcare clinics that perform abortions or provide abortion referrals from receiving Title X funds. The rule was officially enforced yesterday. Here’s a quick rundown on what’s happening and what all of this means for reproductive and women’s health.
Title X is a federal grant program dedicated solely to providing family planning services and related reproductive health services including birth control, STI screenings and breast/cervical cancer screenings for low-income patients.
As the only federal grant program dedicated to these services, Title X is crucial for the health of millions of Americans. Nearly 4,000 clinics nationwide receive Title X funding, allowing them to provide services for around four million people a year. The program is especially important for underinsured or uninsured low-income people of color who often use Title X-funded clinics.
In March 2019, the Trump administration issued a domestic abortion “gag” rule. This rule was fully enforced yesterday (on September 18th, 2019).
The new rule states that health clinics can’t receive certain funding from Title X if they provide abortions or refer patients to other health centers that provide abortions. The rule is meant to create seperation between facilities, programs and any other health services using Title X funds from those that provide abortions. The rule still allows providers to offer “nondirective counseling” on abortion, which means doctors can still go over treatment options with patients in order to make sure they get all of the information they need to make the best decision about their health. However, nondirective counseling would prohibit a doctor from telling a patient where they could go to get an abortion, even if the patient requested this information.
So what does this all mean?
This rule has left facilities receiving Title X funding in a predicament. They can either stop receiving funding from Title X or stop providing abortion services and referrals to patients. If a clinic provider wants to talk to patients about ways to access a safe and legal abortion, they can’t receive Title X funding for other health services they provide like affordable birth control or STI screenings.
Note: Federal law already prohibits the usage of Title X funds to pay for an abortion, and federal Medicaid funding also doesn’t cover abortions except in rare circumstances. Under this rule, Title X-funded facilities can no longer provide abortion services and receive Title X funding for other non-abortion services at the same time — even though none of these funds were used to cover abortion services in the first place.
In August, Planned Parenthood, which treats 40% of all Title X patients in the country, decided to withdraw from the federal program, instead of stopping abortion services and referrals in their clinics. Planned Parenthood is not the only one. Main Family Planning and Public Health Solutions, a group of clinics in Maine and New York, respectively, also announced they would leave the Title X program.
This new rule not only impacts a patient’s ability to receive information about accessing a safe and legal abortion, but also has devastating consequences on those who rely on Title X for comprehensive preventative care and women’s health services. Before Trump’s gag rule, health clinics used Title-X funds to cover 720,000 Pap tests, almost 2 million breast exams and more than 4 million STD tests. Furthermore, funds from the program were also used to prevent about 1 million unintended pregnancies annually, through birth control and other contraception. With so many clinics leaving the Title X program, many low-income patients will now have to travel further distances, endure longer wait times and take time off of work to receive care. The new rule will deny many women the healthcare they need and is a huge step backwards for reproductive and women’s health.