The Trump Administration formally came out Friday in favor of cutting off federal family planning money to organizations that perform abortions or make referrals for them.
The rule change affects Title X, the $260 million federal program which underwrites the costs of contraception, reproductive health services and STD screening for low-income and uninsured patients.
The fundamental premise of this Title X change is as simple as it is controversial: The administration believes abortion is not “family planning” and the two do not belong in the same place or conversation.
NPR broke out the details further, saying it “would require facilities receiving federal family planning funds to be physically separate from those that perform abortion; would eliminate the requirement that women with unintended pregnancies be counseled on their full range of reproductive options; and would ban abortion referrals.”
The White House says this change fulfills Trump’s “promise to continue to improve women’s health and ensure that federal funds are not used to fund the abortion industry in violation of the law.” Critics call it a “gag rule” that prevents caregivers from giving patients full information and makes good on Trump’s vow to defund Planned Parenthood.
In a conversation with Glamour this week, Sen. Elizabeth Warren slammed the Title X proposal as bad policy that could endanger women.
“Forcing doctors to keep information from patients about their health options is dangerous and just plain wrong,” the Massachusetts Democrat said.
What Trump is pursuing isn’t new: He’s bringing home the essence of the so-called “Mexico City Policy,” which cuts off federal funding to worldwide health groups that perform abortions or even provide information about them.
The proposal now on the table could have an outsized effect on Planned Parenthood, which offers a variety of reproductive and wellness services in addition to abortion. According to Kaiser Health News, “Planned Parenthood affiliates account for about 13 percent of total Title X sites but serve an estimated 40 percent of its patients.”
Federal law has long prohibited the use of public money to subsidize abortion procedures. But Warren, who was among many lawmakers who signed a letter protesting the Title X changes, says “there’s a lot more on the line as well.”
The Title X rule change “demands that multi-service providers not put a woman’s best interest first — and that if they do, they will lose federal funding for the full array of healthcare services,” Warren said. “That’s shocking.”
“Accessible contraceptives, services to help women prevent unplanned pregnancies [and] care for children after they’re born are all under attack by the Republicans,” she added.
Warren also called the fight a matter of equity. “Threatening to cut back on basic health care services disproportionately hits communities of color, the uninsured and low-income women,” she said.
“This is about personal liberty, but it’s also about women having full economic participation in this country. Women who can’t get access to basic reproductive service health care services have fewer economic opportunities going forward. An unplanned pregnancy can derail an education or the early steps of a career.”
Planned Parenthood sized up the significance of the current Title X change in a blunt Friday email to reporters: “For nearly two decades, Title X law has been clear: Health care providers cannot withhold information from you about your pregnancy options. This rule means they can.”
The White House, however, sought to frame the new proposal as simply shoring up existing law.
“The new proposed rule would not cut funds from the Title X program. Instead, it would ensure that taxpayers do not indirectly fund abortions,” the press secretary’s statement said. “Contrary to recent media reports, HHS’s proposal does not include the so-called ‘gag rule’ on counseling about abortion that was part of the Reagan Administration’s Title X rule.”
The Reagan version of the rule was similar, but not identical, to the Trump iteration. It called for separate facilities for abortions and said Title X recipients could not disseminate information about, or advocate for, terminating a pregnancy.
Called a “gag rule” for prohibiting doctors from talking to patients about abortion, Reagan’s policy got bogged down in court battles and “never went into effect as written, although the Supreme Court ruled it was an appropriate use of executive power,” as the Associated Press reported. His Democratic successor, Bill Clinton, ultimately rescinded it in 1993.
While Vice President Mike Pence—along with his wife, Karen—is a stalwart conservative known for a desire to end abortion in the U.S., Trump himself has come a long way from the self-described “very” pro-choice views he once held.
Days after his 2017 inauguration, Trump reinstated the “Mexico City” order, known by detractors as the “global gag rule.” This past January, he became the first sitting president to address the annual anti-abortion March for Life in Washington via video link. And on May 22, Trump keynotes a “Campaign for Life” gala hosted by the anti-abortion group Susan B. Anthony List.
“The ‘Protect Life Rule’ would not cut a single penny of family planning funding,” said Mallory Quigley, a spokeswoman for Susan B. Anthony List, said in support of Trump’s Title X stance. “This is simply about responding [to] a desire on the part of American taxpayers, six in 10 of whom do not want to be complicit in abortion through their federal funds and taxpayer dollars.”
Dawn Laguens, executive vice president of Planned Parenthood Federation of America, said pro choice advocates would “not stand by while our basic health and rights are stripped away.”
“Everyone has the right to access information about their health care—including information about safe, legal abortion—and every woman deserves the best medical care and information, no matter how much money she makes or where she lives. No matter what,” she said in a statement. “They won’t get it under this rule.”
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