(CN) – Citing a Trump administration "gag rule" barring federally funded clinics from referring women to abortions, Planned Parenthood said Monday it will exit the $286 million Title X program that provides reproductive health care to 4 million low-income and uninsured patients.
"We consider ourselves being forced out of the Title X program because we cannot comply with the gag rule," Planned Parenthood Acting President and CEO Alexis McGill Johnson said during a press call Monday.
McGill declined to specify how much money Planned Parenthood, which serves 41% of Title X patients, will give up by leaving the program. Emergency funds will be used to help some patients, she said, but exiting the program will cause longer wait times and delays for patients. Some women will be forced to drive hundreds of miles to get birth control while others will go without cancer screenings and other critical services, she said.
In March, U.S. Health and Human Services Secretary Alex Azar introduced a new rule requiring Title X-funded providers maintain “clear financial and physical separation” from centers that perform abortions. The so-called “gag rule” also forbids Title X-funded providers from discussing abortion with patients and requires referring pregnant women to prenatal care, even if they plan to end their pregnancies.
Before the new rule could take effect May 3, three judges in Washington state, Oregon and California granted preliminary injunctions against it. A unanimous three-judge Ninth Circuit panel then stayed the injunctions in June.
Opponents of the “gag rule,” including 21 states and Washington D.C., asked for an en banc rehearing of the panel's decision. Last month, an 11-judge en banc panel refused to revive the injunctions pending review of the case. The 11-judge panel scheduled oral arguments for Sept. 23 in San Francisco.
The Trump administration set a deadline of Aug. 19 for Title X recipients to submit letters on their plans to comply with the new requirements. Planned Parenthood said it would submit letters by the deadline informing the government of its decision to exit the program.
"When you have an unethical rule limiting what our providers can tell our patients, it becomes really important for us to not agree to be in the program," Johnson said.
Opponents of the gag rule say the policy will disproportionately impact low-income people, minorities and patients in rural areas that rely on Title X clinics for cancer screenings, HIV testing and birth control.
Governors in five states – Hawaii, Illinois, New York, Oregon and Washington – said they will not participate in the Title X program under the conditions imposed by the Trump administration. Legislatures in Massachusetts and Maryland passed laws refusing to accept Title X funds with the "gag rule" in place. Maine Family Planning, the only Title X-funded provider in Maine, also declined $2 million per year in federal funds due to the Trump administration policy.
Health and Human Services maintains it is not responsible for providers losing Title X funding because they knew the requirements when they applied for grants this year.
"Some grantees are now blaming the government for their own actions – having chosen to accept the grant while failing to comply with the regulations that accompany it – and they are abandoning their obligations to serve their patients under the program," department spokeswoman Mia Heck said in an emailed statement.
Heck added Health and Human Services is grateful for the many grantees who continue serving patients under the program and that it "will work to ensure all patients continue to be served."
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