Clinics That Refer Women For Abortions Would Not Get Federal Funds Under New Rule

May 18, 2018
Originally published on May 18, 2018 6:28 pm

Updated at 11:40 a.m. ET

The Trump administration is reviving a rule that would deny federal family planning funds to organizations that provide abortions or make abortion referrals.

The rule is similar to one in place during the Reagan administration. The proposal was drafted by the Health and Human Services Department and is under review by the White House budget office.

The proposed regulation would apply to Title X, the federal program that provides at least $260 million annually for contraception, screenings for sexually transmitted diseases and other reproductive health services to millions of low-income people, according to the official, who asked not to be named.

The rule change would put Planned Parenthood back in the crosshairs after repeated attempts by congressional Republicans to defund the family planning group, which provides abortions but says the federal money it receives does not go toward paying for the procedures.

Under current law, federal funding for abortions is prohibited in most cases. However, anti-abortion-rights advocates have long made cutting funds to any group providing abortions or referring patients for abortions a high priority.

The new rule would also bar federal funds for any group that refers patients for abortions.

Abortion-rights supporters have described the proposal as a "gag rule" and say it would undermine reproductive health care for low-income patients.

On NPR's Morning Edition on Friday, Cecile Richards, former president of Planned Parenthood, told Steve Inskeep: "I think, really, the chilling thing about what they're proposing now is it removes the guarantee that women in particular are getting full and accurate information about their health care from their doctor. This is absolutely extraordinary that we would now be gagging doctors and health care providers from giving women their legal information and even referring them for potentially livesaving health care."

She said the rule change would mean that if a pregnant women with cancer came in, "her health care provider could refuse to tell her that abortion is legal, that it's even an option."

In a statement from Planned Parenthood Federation of America, the group said it would not "stand by while our basic health rights are stripped away."

"This is an attempt to take away women's basic rights, period. Under this rule, people will not get the health care they need. They won't get birth control, cancer screenings, STD testing and treatment, or even general women's health exams," Executive Vice President Dawn Laguens said.

"Everyone has the right to 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. They won't get it under this rule," she said.

However, anti-abortion-rights groups praised the proposed change. Students for Life of America, which says it has members on more than 1,200 U.S. university and high school campuses, said in a statement:

"These changes are long overdue as abortion is not healthcare or birth control and many women want natural healthcare choices rather than hormone-induced changes," the group's president, Kristan Hawkins, said. "The Trump Administration has every right to require that Title X programs focus on healthcare, not abortion, and to keep such programs aimed at helping women make a plan for a family outside of the facilities designed to making sure women don't have a family at all."

A similar rule proposed during the Reagan administration was hit by legal challenges from Planned Parenthood and other groups and never fully implemented. It was later rescinded by President Bill Clinton.

Abortion-rights groups are likely to take to the courts again in efforts to stop the latest change, if the proposal goes forward.

"This 'gag rule' is not only unconscionable, but it undermines medical ethics by forcing health care professionals to withhold accurate and timely medical information from patients," Dr. Jenn Conti, a fellow with Physicians for Reproductive Health, said in a statement Thursday.

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Defunding Planned Parenthood has been a priority for social conservatives and a campaign slogan for many Republican politicians. Here's what Donald Trump said to CNN when he was running for president in 2016.


PRESIDENT DONALD TRUMP: It's like an abortion factory, frankly. And you can't have it. And you just shouldn't be funding it. And that should not be funded by the government.

SHAPIRO: Now the Trump administration is moving toward that goal. It's proposing new regulations on federal money that goes towards family planning. NPR's Sarah McCammon joins us to talk more about this proposal. Hi, Sarah.


SHAPIRO: What would this proposed rule do?

MCCAMMON: Well, the official rule has yet to be published. But Trump administration officials have released details of a plan that could in effect cut millions of dollars in federal funding to Planned Parenthood and other groups. The rule is expected to focus on Title X. That's a federal program that provides at least $260 million a year in family planning services for low-income people. So under the Trump administration proposal, organizations that perform or refer patients for abortions would not be able to receive those Title X funds.

And I should point out, Ari, it's already illegal to pay for abortion with federal funds in most cases. But the biggest change here is that if an organization provides or refers for abortion, it couldn't receive that money, even for other reproductive health services, things like contraception, STD screenings.

SHAPIRO: Assume that this rule goes into effect. How much of a victory is this for abortion rights opponents?

MCCAMMON: Well, as you might expect, anti-abortion rights groups are applauding this announcement. It's something they've been pushing for for a very long time. They say they don't want federal dollars in any way going to groups like Planned Parenthood. And earlier this month, a group of abortion rights opponents and close to 200 members of Congress sent letters to the administration asking that the so-called Reagan rule be reinstated. That was a similar Reagan-era policy that took effect only briefly, and these advocates wanted to bring it back.

SHAPIRO: What are groups like Planned Parenthood and other abortion rights activists saying today?

MCCAMMON: Well, they're pointing out that in many parts of the country, Planned Parenthood is one of the largest or the largest provider of Title X services. So not only would it be a financial blow to that organization, reproductive rights advocates say it would also hurt low-income patients who rely on Planned Parenthood for those services. And they say it would interfere with the ability of doctors to talk to their patients about abortion.

SHAPIRO: So if federal money hinges on medical providers not referring or performing abortions, what would the rules be for what medical providers can say to their patients who might be interested in having this procedure?

MCCAMMON: Yeah. That's a really big question, and it's not totally clear. The guidance we're getting from the Trump administration says two things. On the one hand, quote, "the proposal will not prohibit counseling for clients about abortion, but neither will it include the current potentially illegal mandate that projects must counsel and refer for abortion," unquote. And that's referring to an Obama administration rule.

SHAPIRO: So that could even be so much as saying, here's the name of an organization that might perform the procedure you're looking for, even though we don't.

MCCAMMON: Right. I mean, that is kind of what is subject to interpretation because on the other hand, this same guidance from the Trump administration says that it would bar Title X funding for, quote, "any program or facility where abortion is performed, supported or referred for as a method of family planning." So how that plays out is unclear.

Reproductive rights advocates are calling it a gag rule. Planned Parenthood says it would stop doctors from having those conversations. Anti-abortion rights groups are steering clear. They don't want to call it a gag rule. And they point to that counseling language to suggest that talking about abortion would be OK. I've asked the White House to clarify, but I don't have that clarification yet.

SHAPIRO: NPR's Sarah McCammon. Thanks a lot.

MCCAMMON: Thank you. Transcript provided by NPR, Copyright NPR.