Family planning

Title X: Biden Administration Overturns Trump Rule Barring Federally Funded Family Planning Clinics From Referring Abortion

The Biden administration revoked a Trump-era rule that had become a flashpoint in the abortion wars, saying Monday it would no longer block clinics that receive federal family planning assistance from advise people to terminate their pregnancies.

The new rule in the half-century-old family planning program known as Title X will allow health centers to receive federal funds even if they refer patients for abortions. It takes effect on November 8.

The rule reverses a move initiated in 2018 by President Donald Trump to appeal to social conservatives critical to his political base, siding with them in a long-running battle with the Planned Parenthood Federation of America and other groups. of family planning.

“Today more than ever, we are making it clear that access to quality family planning care includes accurate information and referral – based on patient need and referral,” the health secretary said. and Social Services, Xavier Becerra, in a statement accompanying the review.

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Federal health officials released the rewrite as national abortion laws were brought to the forefront of legal and policy debate. Roe vs. Wadethe 1973 Supreme Court decision that entrenched the right to abortion in the United States, is under renewed attack as the composition of the High Court has become increasingly conservative.

A month ago, a split Supreme Court said a new Texas abortion law that bars the procedure as early as the sixth week of pregnancy could go into effect while the law’s legality is debated in court. law courts. And the high court is considering a Mississippi law, blocked by lower courts, that would ban nearly all abortions after 15 weeks’ gestation.

Critics of the Trump administration’s rewrite of the Title X policy derided it as an “abortion gag rule” that limited what doctors and other healthcare practitioners could discuss with patients. Rather than heed the restrictions, Planned Parenthood affiliates, which serve about 4 in 10 patients in the program, along with other health centers, lost the Title X funds that had been the mainstay of their work.

An estimated 981 clinics — about 1 in 4 that received Title X money — dropped out in 2019, and half a dozen states no longer had health centers in the program, according to the Guttmacher Institute. , a reproductive rights research and policy organization.

The number of patients served by Title X grants decreased by 2.4 million from 2018 to 2020, according to the program’s latest annual reports. He estimates that nearly two-thirds of that decline is due to Trump administration restrictions.

More than 20 states, which also receive a portion of the $286 million in family planning grants, have filed federal lawsuits to try to prevent the restrictions from taking effect. Lower courts in Maryland and the West Coast issued injunctions that temporarily blocked them. But in the summer of 2019, a California appeals court ruled that the Trump rule could begin while litigation unfolds. And after giving protesting Title X attendees an additional two months to signal their intent to comply with the rule, Trump health officials put it into effect. In February 2020, the United States Court of Appeals for the 9th Circuit ruled in a split decision in favor of the restrictions.

Reaction to the new rule has been split along ideological lines, with abortion rights groups praising the changes and anti-abortion groups disparaging them. Alexis McGill Johnson, president of Planned Parenthood, called the abandonment of the Trump rule “a big win for patients and a big win for sexual and reproductive health care.” She said in an interview that, based on conversations with affiliates who stepped down during Trump’s tenure, they have “a strong desire. . . to be back in the program” and plan to reapply as soon as possible.

Connor Semelsberger, director of federal affairs at the anti-abortion Family Research Council, lambasted the Biden administration. He said in a statement that “it’s no surprise” that he “has moved with lightning speed to . . . send millions of taxpayer dollars to the biggest abortion company in the world.” United States, Planned Parenthood.

Title X has been an ideological lightning rod since shortly after its creation in 1970 under President Richard M. Nixon as part of the federal Public Health Act. It is intended primarily to help the poor or the uninsured.

The program has always prohibited the use of federal money to directly pay for abortions. But the Trump rule went further, prohibiting health centers that receive Title X money from referring pregnant women elsewhere for abortions. The rule did not go as far as an earlier version, in place during the Reagan era, which banned all abortion counseling.

The Trump rule allowed clinics to provide “non-directive pregnancy counseling, including non-directive abortion counseling,” but said they were not required to do so.

Additionally, the Trump rule stated that clinics that used other sources of money to perform abortions were required to create a “clear physical and financial separation” for those services. Critics have argued that this part of the rule is a weapon against Planned Parenthood clinics, seeking to induce them to withdraw from Title X by making it more difficult — in some cases, impossible — for them to operate. This part of the rule has now been removed.

Monday’s regulatory action follows a presidential memorandum Biden posted in January, a week after taking office, which triggered the rule change. The memo says her administration will pursue policies that allow women “to have access to the health care they need.” Biden’s memo singled out Title X, saying his predecessor’s rule “puts women’s health at risk by making it harder for women to receive comprehensive medical information.”

Biden also said at the time that his administration’s policies would “support the sexual and reproductive health and rights of women and girls in the United States and around the world.” As part of the memo, the president lifted the so-called “Mexico City policy,” which has swung for nearly three decades depending on whether Republicans or Democrats have been in the White House. .

As a condition of receiving global family planning assistance from the United States, the Mexico City Rule, when in effect, required nonprofit organizations to certify that they would not use money from any source to perform or promote abortions. Before Biden rescinded it, the Trump administration expanded that rule to also apply to other types of U.S. international aid.

In April, the Department of Health and Human Services proposed the Title X rule which now becomes final.

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