WASHINGTON -- The Trump administration on Tuesday formally issued its barring health clinics who accept federal Title X funding from referring patients for abortions, as well as mandating complete physical and financial separation of abortion-related activities from other services funded through Title X.
Similar restrictions had been promulgated during the Reagan administration, which also prevented clinics from even mentioning abortion to clients. The new rule does not go that far.
"The proposed update to the regulations ensures compliance with statutory program integrity provisions governing the program and, in particular, the statutory prohibition on funding 'programs where abortion is a method of family planning,'" the Department of Health and Human Services . "The proposed update to the regulations, which were last revised 18 years ago, would also make notable improvements designed to increase the number of patients served and improve their quality of care."
In particular, "The Title X program serves approximately 4 million people annually, and the proposed update seeks to ensure a holistic and health-centered approach; safeguarding the short and long-term family planning needs of more women, men, and adolescents in need of services," the release continued.
"It is of utmost importance that individuals in low-income communities receive comprehensive family planning services, and care that promotes the welfare of adults and youth. It is equally important that, as stewards of taxpayer funds, the department assures that the program operates according to statutory requirements."
The proposed rule, which was sent last Thursday to the Office of Management and Budget for review, states that "Title X [recipients] may not perform, promote, refer for, or support, abortion as a method of family planning, nor take any other affirmative action to assist a patient to secure such an abortion."
"If asked, a medical doctor may provide a list of licensed, qualified, comprehensive health service providers (some, but not all, of which also provide abortion, in addition to comprehensive prenatal care), but only if a woman who is currently pregnant clearly states that she has already decided to have an abortion," the rule continues. "This list is only to be provided to a woman who, of her own accord, makes such a request. The list shall not identify the providers who perform abortion as such."
Some of the other proposed changes to the $287 million Title X program include:
- Requiring clear financial and physical separation between Title X funded projects and programs or facilities where abortion is a method of family planning. "This separation will ensure adherence to statutory restrictions and provide clarity about permissible and impermissible activities for Title X projects," the release said.
- Requiring clinics to encourage meaningful parent/child communication and, as required by federal law, encourage family participation in a minor's decision to seek family planning services, giving practical ways to begin – and maintain – such communication.
- Permitting individuals to qualify for Title X services if they are unable to obtain employer-sponsored insurance coverage for certain contraceptive services due to their employer's religious beliefs or moral convictions.
The proposed regulation had its critics. "I am disgusted that the Trump administration is once again prioritizing extremist ideology over women's health," said Rep. Frank Pallone (D-N.J.), ranking member of the House Energy & Commerce Committee, in a . "This proposed rule is a blatant attack on reproductive healthcare providers and only serves to seriously impair women's access to and information about the full range of reproductive healthcare services."
"Under this proposal, low-income women will lose access to contraceptive services and related preventive healthcare, and providers will be forced to choose between giving their patients complete medical information or complying with a restriction on speech. This rule stigmatizes patients who seek information about their pregnancy options and is a radical departure from how healthcare should be provided in this country."
Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association, also criticized the rule, saying in a statement that it would "effectively ban providers from referring or counseling patients for abortion care, even upon a patient's request, and also threaten patient confidentiality in the name of family participation, despite the fact that the standard of care dictates that client values should guide clinical care."
"The proposed rule would also impose onerous physical separation requirements ... for family planning providers that offer referral or abortion care," Coleman said. "The long-term health consequences of decimating the nation's family planning program would be dire. We would see a dramatic reduction of critical health services, resulting in an increased rate of unintended pregnancies and [sexually transmitted diseases]. The public health community implores the Trump administration to stop its unrelenting assault on birth control and preventive care."
President Trump praised the proposed rule in a speech to The Susan B. Anthony List, an anti-abortion rights group, Tuesday evening. "Today we're making [an] historic announcement," he said. "For decades, American taxpayers have been wrongfully forced to subsidize the abortion industry through Title X funding, so today ... my administration proposed a new rule to prohibit Title X funding from going to any clinic that performs abortions."
Although the president didn't mention any clinics by name, the statement appeared to be aimed particularly at Planned Parenthood, which performs abortions at some of its facilities and is currently the largest recipient of Title X funding.
While he was speaking on the topic, Trump took the opportunity to promote another abortion-related effort. "We're also seeking passage of the 20-week abortion bill, which would end painful late-term abortions nationwide," he said. "The House just passed [such] a bill, and the Dem0crats in the Senate are doing everything within their power to block [it there]."
Trump noted that "For the first time since Roe v. Wade, America has a pro-life president, a pro-life vice president, a pro-life House, and 25 Republican state capitals; that is pretty good ... When I ran for office, I pledged to stand for life and as president that's exactly what I've done, and I've kept my promises."