The rule, which has been expected for months, is almost certain to be challenged in court. It also requires organizations that receive funding under the program, called Title X, to have “physical and financial separation” between abortion-related services and programs that involve birth control or other family planning services. Organizations that receive federal funds have already been prohibited for years from using it to finance abortion services.
The rule does not prevent Title X programs from talking about abortion with patients, just from telling them where they can obtain one. But it removes a requirement that the programs counsel women on all reproductive options, including abortion, a change that would make anti-abortion providers eligible for funding.
“Trump’s domestic gag rule harms women in more ways than one,” Stephanie Schriock, president of Emily’s List, said in a statement. “It effectively dismantles Title X, forces doctors to lie and forbids them from referring their patients for abortion, and prevents women from being able to access Planned Parenthood’s services.”
Anti-abortion organizations heralded the regulation as a long-sought victory. “The finalized ‘protect life rule’ draws a bright line between abortion and family planning programs,” Tony Perkins, president of the Family Research Council, said in a statement, adding that the rule will loosen Planned Parenthood’s “hold on tens of millions of tax dollars.”
Title X provides $286 million in funding for programs that provide services like birth control, screening for breast cancer and cervical cancer, and screening and treatment for sexually transmitted diseases. These programs serve about 4 million patients each year, many of them poor, at more than 4,000 clinics. About 40 percent of those clinics are operated by Planned Parenthood, which receives close to $60 million in Title X funds each year.
“The Title X gag rule will essentially dismantle this critical federal program,” said Dr. Leana Wen, president of the Planned Parenthood Federation of America. “In many parts of the country Planned Parenthood is the only provider who participates in the program.”
The new rule is the most recent step in a series of Trump administration efforts to shift the direction of federal health programs toward conservative policies. The administration has expanded the ability for employers to claim religious or moral objections to the Affordable Care Act’s requirement that they offer employees insurance coverage for contraception. It has channeled funding for teen pregnancy prevention programs and family planning grants into programs that emphasize sexual abstinence over contraception.
The changes are being challenged with numerous lawsuits by groups that support reproductive rights, but they have broad support among evangelicals, which comprise a large block of the president’s political base.
Dr. Niva Lubin-Johnson, president of the National Medical Association, which represents African-American physicians and their patients, said that if Planned Parenthood is no longer funded by Title X, other providers funded by the program would have to increase their caseloads an average of 70 percent to care for the 1.6 million people who currently receive Planned Parenthood’s Title X-financed services.
“Many providers have already said they would be unable to fill this gap,” Lubin-Johnson said. “This rule will have dire and disproportionate consequences for African-American patients, who make up 22 percent of people who access health care through Title X.”
Most of the changes required by the new regulation will be phased in beginning 60 days after it is published in the Federal Register. Compliance with the financial separation is required 120 days after publication and clinics have a year to comply with the physical separation requirements.
This article originally appeared in The New York Times.