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The Trump administration is now blocking clinics in a nationwide family planning program from referring patients for abortions.
The Department of Health and Human Services told providers Monday that it would move ahead with enforcing its long-proposed changes to Title X, a $286 million federal program dedicated to supporting family planning services like contraception and STI screenings, after a series of legal battles cleared the way.
Beyond the ban on abortion referrals, providers must now maintain a financial separation between any services that include abortion and those that don’t. It’s already illegal to use federal dollars to pay for abortions, but Trump officials and anti-abortion advocates have argued that changing Title X’s rules is necessary to keep funds from “intermingling.”
The changed rules stipulate that clinics must also physically separate these types of services, but providers will have until next year to comply with that requirement.
Almost 4,000 clinics used money from Title X in 2017, according to the Kaiser Family Foundation. Many are now weighing whether they can remain in the program and follow its new rules, or if they can afford to leave.
Planned Parenthood, which provides care to about 40 percent of the 4 million low-income people who use Title X, has already repeatedly said it will leave the program rather than comply with what its head, Leana Wen, calls a “gag rule” on physicians. In a statement to the Associated Press, Wen promised, “Our doors are still open.”
“We will not stop fighting for all those across the country in need of essential care,” she added. Right now, the organization is not complying with the Title X changes, and instead operating on limited emergency funds.
Before the rule change, providers in Title X were required to offer pregnant patients “neutral, factual, non-directive information on all pregnancy options,” Adam Sonfield, senior policy manager at the Guttmacher Institute, told VICE News last month. That included parenting, adoption, and abortion — including, if the patient wanted one, a referral to an abortion provider.
“The administration has eliminated that as a requirement, so that providers — say, providers who may have a particular ideological bent — may provide counseling that skews people, skews patients towards one of those options over another,” Sonfield explained. “It explicitly bans providers from providing a referral for abortion, and requires them to refer all patients for prenatal care, regardless of the patient’s wishes.”
Under the administration’s new rules, if a patient wants an abortion, a doctor or some types of nurses are allowed to give them a list of health care providers who offer a wide range of services. Some of the providers on that list can also offer abortion services (but they’re not allowed to make up the majority of the list). The doctor is not allowed to tell the patient which clinics on the list offer abortions.
Planned Parenthood and other reproductive health groups have already sued to halt the changes to Title X. Several of those lawsuits, however, are still winding their way through the courts. Language to block the administration’s restrictions also passed the House in an appropriations measure earlier this year, and advocates are now looking to convince the Republican-controlled Senate to approve it.
Cover: Abortion-rights supporters take part in a protest Thursday, May 30, 2019, in St. Louis. (AP Photo/Jeff Roberson)