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Planned Parenthood to stop taking Title X funds rather than comply with abortion ‘gag rule’

Planned Parenthood
A Planned Parenthood clinic in New York.
(Andrew Burton / Getty Images)

Planned Parenthood said Monday it will withdraw from the federal Title X program that helps low-income people access contraception rather than comply with what it calls a new Trump administration “gag rule” that prohibits it from providing abortion referrals to those patients.

The announcement comes amid a protracted legal battle with the White House over changes to the nearly 50-year-old Title X program, which annually provides $286 million to healthcare providers to fund family planning services such as birth control. The administration required grantees to explain by Monday how they would comply with the new rule.

All seven Planned Parenthood facilities that are direct grantees in the program and hundreds of “sub” grantees that received funding through a third party will withdraw from Title X, said Alexis McGill Johnson, acting president and chief executive of Planned Parenthood Federation of America. Nationwide, Planned Parenthood currently serves 1.5 million low-income people under the program.

The Trump administration has “forced Planned Parenthood grantees out of Title X,” McGill Johnson said. “We at Planned Parenthood will refuse to cower to the Trump-Pence administration.”

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McGill Johnson said that Planned Parenthood’s doors will remain open and that it will continue to provide contraception services, relying on “emergency” funding from other sources in the case of Title X patients. But she indicated it would be a strain for the group. “Using essentially fundraising for charity — what should be a state responsibility, a federal responsibility — [...is] like holding an umbrella during a tsunami,” she said.

Several states have pledged to try to come up with new funding to replace the federal dollars. The impact is likely to vary state by state. In some parts of the country, Planned Parenthood is the only Title X grantee, and in some regions, the state acts as a grantee, with several subgrantees, including Planned Parenthood facilities and other healthcare providers.

The decision by Planned Parenthood — which gets about $60 million in funding and is the program’s largest grantee — is the latest in a years-long battle between abortion-rights supporters and Republicans, who have advocated the elimination all federal funding for abortion providers and the “defunding” of Planned Parenthood.

If Planned Parenthood’s decision to exit the Title X program holds amid the ongoing legal battle, it would mark one of the antiabortion movement’s most prominent recent victories.

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The Trump administration’s new policy affects all 4,000 of the country’s Title X-funded facilities.

Essential Access Health, which administers the Title X program in California, has filed suit against the policy, but indicated Monday that it will comply with the new regulations.

The group submitted a plan to the Department of Health and Human Services to keep the state’s extensive Title X network in place “while continuing the fight to halt implementation of the regulations in court,” according to Julie Rabinovitz, president and chief executive.

Essential Access Health declined to reveal details of the plan.

But since the group’s network includes several Planned Parenthood facilities, those facilities will suspend participation in Title X.

Planned Parenthood plays an outsize role in the Title X program, treating 41% of its patients in the country.

Planned Parenthood last week asked the 9th U.S. Circuit Court of Appeals for an injunction to block the policy while it and other healthcare organizations appealed the court’s earlier decision to allow the administration’s new policy to move forward. The group warned in a letter last week that without emergency action by the court, it would “now have no option but to withdraw from the Title X program.”

The court has agreed to revisit the issue at oral arguments the week of Sept. 23, raising the possibility that Planned Parenthood may yet win an injunction to delay the rule pending the court fight.

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The policy does not prevent healthcare providers from mentioning abortion, but it prevents them from making a referral or telling patients where they could get one. Planned Parenthood and the American Medical Assn., which is also suing the administration over the policy, call it a “gag rule” because it interferes in a doctor’s relationship with the patient and his or her ability to provide the care they think is best.

The Trump administration argues that its policy would ensure that taxpayers are not indirectly funding abortions, a top priority of antiabortion groups. The Title X program already prohibits participants from using any of the money to fund abortions.

In a letter to the 9th Circuit last week, Justice Department lawyer Jaynie Lilley said, “Nothing in the rule will lead to the ‘expulsion from the Title X program’ of Planned Parenthood or any other grantee.”

“As relevant here, the rule merely requires grantees to refrain from providing referrals for abortions,” Lilley wrote. “If the seven Planned Parenthood direct grantees insist on providing abortion referrals even within a federally funded program, and feel so strongly that they would withdraw from the program and the public they serve, that is their own choice, not a consequence of the rule.”

The Trump administration said Monday that any Title X grantee who participated in the program this year did so with full knowledge of the conditions that went along with it and suggested that Planned Parenthood is abandoning its obligation to patients.

“Some grantees are now blaming the government for their own actions — having chosen to accept the grant while failing to comply with the regulations that accompany it — and they are abandoning their obligations to serve their patients under the program,” said Mia Heck, director of external affairs at Health and Human Services’ Office of the Assistant Secretary for Health.


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