A new government gag rule, announced in February by Health and Human Services (HHS), prohibits healthcare clinics from referring their patients to abortion services or conducting them. This is a recent addition to Title X, a federal healthcare program dating back to 1970.
Title X that grants around $260 million dollars to family planning clinics a year. Planned Parenthood makes up about 13 percent of these grantees by itself, but as of 2018 served 41 percent of Title X patients. California alone serves over 700,000 Title X patients annually.
Under the new legislation, Title X grantees would not be allowed to perform abortion services onsite or speak to patients about abortion. Clinics must also financially separate all abortion services from their Title X funded ones.
Planned Parenthood, along with 20 plus states and the American Medical Association, is currently challenging the new rule in court after HHS asked clinics to either comply or withdraw from the program by August 19.
Rather than compromise their view of doctor-patient integrity, Planned Parenthood officials withdrew from the federal plan. Many pro-life groups view this as a hard fought victory.
However, Dr. Maia Uli is an employee of a local Planned Parenthood with a first hand view of the repercussions for healthcare organizations as a whole.
“Over 50 community clinics in San Diego County are receiving [Title X] funding. They now have to decide to either comply with the rule or risk losing substantial funding that keeps the doors open,” said Uli. “Part of the patient-physician relationship is giving [patients] all the information and so it’s very hard for these clinics to face this predicament.”
Planned Parenthood is a main provider of reproductive healthcare for low income women nationwide. In Vermont, 100 percent of Title X recipients are Planned Parenthood patients. The gag rule also places restrictions on global US affiliates using Title X funding for reproductive care.
“Currently, 50 percent of pregnancies are unintended. If you limit birth control [by defunding clinics, it] will lead to […] endless consequences from trying to attack abortion but really attacking basic healthcare rights for women and men,” said Uli.
67% of Title X patients fall below the poverty line, and are unable to receive proper care without federal funding. People of color and other minority groups are also disproportionately affected.
According to Planned Parenthood officials, federal funding has been used for contraceptives, STD testing, and other gynecological services.
In accordance with the Hyde Amendment enacted in 1976, taxpayer funds cannot be used for abortion services except in the narrow case of medical emergency, rape, or incest. Although Title X targets these services, its money has never been used to provide them.
As clinics lose federal grants in an effort to protect their medical integrity, the healthcare system will continue to morph. The Title X changes are expected to go into full effect in 2020.