The Trump administration yesterday released a much-anticipated rule proposal to block federal Title X family planning grants from funding abortion clinics and service providers that offer abortion referrals.
The new rule is expected to hit Planned Parenthood and other abortion providers hard. Planned Parenthood alone stands to lose as much as $60 million a year under the rule change if they refuse to disentangle their abortion services from Title X services.
Title X is a federal grant program that provides funding to local public and private clinics exclusively for family planning and contraceptive services for low-income and uninsured individuals.
The new proposed rule will substantially change current federal regulations by preventing Title X grantees from performing, promoting, encouraging or lobbying for abortion as method of family planning. Service providers under the new rule will be required to disentangle abortion-related activities from Title X services and will be prohibited from offering direct abortion referrals or from scheduling abortion appointments for clients.
The proposed rule will also require Title X grantees to comply with state and local laws for reporting cases of child abuse, rape, incest, human trafficking, and intimate partner violence. Planned Parenthood clinics have been known to fail to properly report statutory rape, sex trafficking, and other crimes as required by law.
The rule will also prohibit grantees from using Title X funds for building costs for facilities that may be used for providing abortion services.
Due to a rule change from the Clinton administration, Title X providers currently are required to provide information and counseling on abortion as a pregnancy “option,” stipulating that Title X clinics “must” offer abortion counseling to any woman who requests any sort of information on pregnancy options unless she specifically makes it known that she does not want to receive counseling on abortion.
The new rules proposed by the Trump administration this week would remove this requirement, ending discrimination against service providers with moral or religious objections to providing abortion counseling and allowing them to exercise their right of conscience. Service providers may still offer abortion counseling and information but will no longer be required to do so.
The new proposed rule change appeared yesterday evening on the Department of Health and Human Services (HHS) website.
Pro-life allies have been calling the new rule proposal the “Protect Life Rule” for reinstating much-needed reforms to the Title X program to disentangle federal funding from the abortion services provided by many Title X recipients.
Under the Protect Life Rule, Title X recipients that engage in abortion-related activities will be required to maintain physical and financial separation between their abortion services and Title X services. Recipients that perform or promote abortion will be required to keep separate accounting records for prohibited activities. Clinics may not use the same buildings, examination rooms, waiting rooms, phone numbers, websites, personnel, or workstations for prohibited abortion-related activities. Clinics will also be prohibited from displaying or offering literature, posters, brochures, or other materials that promote or advertise abortion services.
While the Protect Life Rule does not specifically prohibit federal funding for Planned Parenthood and like providers, the Trump administration is providing Planned Parenthood with a choice: either disentangle abortion services from Title X services or lose government funding.
After Medicaid, Title X is the second largest source of government funding for Planned Parenthood. According a report from the Government Accountability Office released earlier this year, Planned Parenthood affiliates spend nearly $60 million a year in funds sourced from Title X grants.
The Protect Life Rule has been compared to the Mexico City Policy due to a number of similarities between the two policies in their application and scope. Much like the Mexico City Policy, the Protect Life Rule prohibits funding for organizations that perform, promote, or lobby for abortion as a method of family planning or that provide funding to other organizations that actively participate in these activities. Like the Mexico City Policy, the rule applies to both direct recipients as well as subrecipient that receive federal dollars through a third party. However, unlike the Mexico City Policy, organizations that perform or promote abortion under Title X may continue receiving funding if they financially and physically separate prohibited activities from Title X services.
HHS has determined that its obligations under federal law on Title X are “most clearly met where there is a clear separation between Title X programs and programs in which abortion is presented or provided as a method of family planning.”
In the supplementary information for the proposed rule, HHS has made clear that it has concerns with requirements under current regulations to provide abortion counseling and referrals contrary to statutory law. HHS also made known that it has concerns with the possible risk of commingling funds between abortion-related services and Title X services as clinics often utilize the same facilities, staff, and resources for both. HHS has also determined that the use of Title X funds for building costs for facilities where abortion services are offered concomitantly creates serious fungibility concerns.
HHS has submitted the rules to the Office of the Federal Register for publication in the Federal Register. The proposed rule will be open to comments from the public for 60 days after it is published in the Federal Register.