The Trump administration is preparing to announce on Friday a far-reaching change in how Title X family planning funds are awarded so that clinics that provide or abortion services or referrals will no longer be eligible — a move that would effectively defund Planned Parenthood by millions of dollars.
Under the proposal to be filed by the Department of Health and Human Services, the $260 million program would require a “bright line” of physical and financial separation between Title X services and providers that perform, support, or refer to abortion as a method of family planning.
These requirements are similar to those that were in place, although they were not enforced, during the Reagan era. Unlike the Reagan regulation, the proposal will not prohibit counseling for clients about abortion, meaning that there’s no “gag rule” that critics of the changes had feared, according to an administration official.
The changes, the official said, reflect the view that taxpayer funds should not be used to fund abortion and that Title X funds are for family planning services, and abortion is not family planning. The updates are also designed to establish more transparency about the activities of grantees and their sub-grantees.
Conservatives are confident that the new rules will withstand a legal challenge, because similar Reagan-era requirements overcame a Supreme Court challenge.
David Christensen, vice president of government affairs for the Family Research Council, said in an interview that those standards required operations receiving Title X funds to be physically and financially separate from those performing abortions.
“Under Reagan, they could not be co-located, they couldn’t refer for abortion,” Christensen said.
Jeanne Mancini, president of the antiabortion group March for Life, praised the administration in a statement Friday for taking action to direct taxpayer dollars to centers that do not promote or perform abortions.
“This money will now be redirected to comprehensive family health and planning centers that don’t perform abortions and understand that abortion is not healthcare,” she said. “The pro-life grassroots will be pleased to see President Trump deliver on yet another pro-life promise, and we look forward to continued progress is restoring a culture of life here in the United States.”
Trump has delivered on several top priorities for abortion foes since taking office. He has appointed several judges with a history of opposition to abortion to federal appellate courts, including Supreme Court Justice Neil Gorsuch. He reimposed a provision that bars federal funds from going to groups overseas that provide abortion referrals, which is known as the Mexico City policy. And he signed legislation that allows states to withhold federal Title X funds from facilities that provide abortion services.
In recent weeks, officials from Planned Parenthood, which receives $50 million to $60 million in Title X funds and which services an estimated 41 percent of the 4 million patients who receive care through Title X, have expressed alarm about what the changes will mean.
Title X-funded health centers provide services such as cancer screenings, birth control, sexually transmitted infection screenings, pregnancy testing, and well-woman exams.
Earlier this week, more than 200 members of Congress — including Sens. Elizabeth Warren (D-Mass.) and Patty Murray (D-Wash.), and Rep. Joseph Crowley (D-N.Y.) — expressed their opposition to the change in a letter to Secretary of Health and Human Services Alex Azar.
“The move would disproportionately impact communities of color, the uninsured, and low-income individuals, and could reverse progress made in critical areas,” they wrote.
Dana Singiser, vice president of public policy for Planned Parenthood Federation of America, said in a statement earlier this week that the new rules would make it “impossible” for patients to get birth control or preventive care from its clinics.
“No one should be worried that their doctor will be forced to lie to them. No one should be kept from the best medical information and care available. No one should be prevented from getting basic care like birth control,” she said.
The administration official said that the changes would not necessarily result in the defunding of Planned Parenthood as long as the group is willing to “disentangle” their abortion related services from family planning services. However, Planned Parenthood officials have argued that informing women of all their choices — including abortion — is an integral part of the family planning discussion.
In an interview before the new policy was announced, the heads of several family planning clinics across the country said that imposing the kinds of restrictions that were proposed two decades ago would have an enormous impact on their operations.
Susan Buchanan, chief executive of the Boulder Valley Women’s Health Center, said the proposal “undermines our ability to provide health-care services to low-income women, and other women who face barriers.”
Buchanan noted that the state had made major strides between 2009 and 2014 through the Colorado Family Planning Initiative, which focused on providing women with long-acting reversible contraceptives. The state’s teen birthrate dropped 50 percent during that five-year period, she said, avoiding at least $66 million in spending on entitlement programs such as food stamps.
“They’re shooting themselves in the foot, really,” she said.
Boulder Valley Women’s Health Center is the only Title X recipient in Colorado that provides abortions: Several years ago, it separated its family planning and abortion provider operations to comply with requirements imposed by then-Gov. Bill Owens (R), but was told these measures were insufficient.
“We separated into two different corporate structures. We had separate books, insurance, separate boards, separate everything,” she said. “And it didn’t work. It didn’t satisfy them, If they truly believe in the fungibility of money, nothing that we do is going to convince them that we’re going to have adequate separation.”