So-Called Abortion Gag Rule of Trump Era Put on Notice

The U.S. Department of Health and Human Services is set to publish a rule that would let Planned Parenthood benefit from a federal grant program supporting clinics that offer reproductive services unrelated to abortion.

(AP Photo/Rick Bowmer)

WASHINGTON (CN) — Moving methodically, the Biden administration took its first steps Wednesday to bring Planned Parenthood back into the fold of the federal government’s $286 million family-planning program.

The largest single provider of abortion services in the country had quit the nearly 50-year-old Title X program in 2019 to protest what was then a newly implemented rule prohibiting any clinic that gets Title X from referring women for abortions.

Though federal law forbids the distribution of family-planning funding to abortion providers, Planned Parenthood nevertheless received about $60 million per year in federal funds to provide some 1.6 million Title X patients with reproductive care including birth control and screening for sexually transmitted diseases.

Former President Donald Trump instituted the so-called abortion gag rule to shore up support from his abortion-opposed Christian base. These groups were quick to speak out Wednesday against the regulatory shift.

“March for Life is strongly opposed to the Biden administration’s proposed #TitleX rules, which appear specifically designed to bring America’s largest abortion provider, Planned Parenthood, back into the taxpayer-funded program and keep pro-life organizations out,” the group tweeted.

Rather than suspend the ban outright, the U.S. Department of Health and Human Services has elected to undergo a monthslong rulemaking process — a move intended to ensure that the proposed changes are held up in court. Proposing reinstatement of Title X regulations from 2000, HHS officials contend that Trump’s policy may have led to up to 181,477 unintended pregnancies. 

More difficult to quantify, the rule continues, is the true impact of the rule “in terms of long-term sexual and reproductive health negative sequelae in the lives of hundreds of thousands of low-income clients and clients of color.”

A 30-day public comment period will begin once the rule appears Thursday in the Federal Register. 

“Ultimately, continued enforcement of the 2019 rule raises the possibility of a two-tiered healthcare system in which those with insurance and full access to healthcare receive full medical information and referrals, while low-income populations with fewer opportunities for care are relegated to inferior access,” the 71-page proposal says. “Given that so many individuals depend on the Title X program as their primary source of healthcare, this situation creates a widespread public health concern. The 2019 rule is not in the best interest of public health.”

Biden’s HHS notes that unintended pregnancies can lead to increased risk of poor maternal and infant outcomes, and that Trump’s rule “likely also resulted in additional costs to taxpayers as a result of an increase in unintended pregnancies, preterm and low-birthweight births, STIs, infertility, and cervical cancer” that arose in low-income clients as a result of the policy change.

“Given the previous success of the program, the large negative public health consequences of maintaining the 2019 rules, the substantial compliance costs for grantees, and the lack of tangible benefits, the Department proposes revoking the 2019 Title X regulations,” HHS wrote.  

Biden’s HHS says it wants to place more emphasis on equity — eliminating racial and ethnic disparities among Title X clients.

At a press conference Wednesday, one reporter asked bluntly why the Biden administration “insist[s] pro-life Americans pay for abortions.” Biden’s press secretary Jen Psaki maintained this was “not an accurate depiction” of how Title X funding works.

Since 1970, Title X grants have allowed clinics to provide services like contraception, STD treatment and cancer screening to low-income populations and women primarily. The law stipulates that taxpayer money can’t go “where abortion is a method of family planning,” but providers that referred women for abortions were still allowed to participate as long as they did used all Title X money for other family-planning purposes. Some 41% of Title X patients — 1.6 million people — received treatment from Planned Parenthood.

Trump’s ban said clinics that used Title X money would have to refer women to prenatal care even if they planned to end their pregnancies. Despite triggering lawsuits from 23 states and every major medical organization,. as well as several Title X grantees, the rule took effect everywhere but Maryland where a federal judge issued an injunction blocking its enforcement.

The Supreme Court agreed in February to resolve the Ninth and Fourth circuit split over whether the Trump administration could deny federal funding to these clinics. Biden’s HHS filed a stipulation to dismiss the case in March. The court has yet to respond to the request.

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