Trump could ban Title X funding for Planned Parenthood

The Trump administration will cut Planned Parenthood out of Title X family planning grants with an executive order expected in early May, according to a White House aide.

It's the most drastic move in President Donald Trump's strategy to reshape Title X. The program offers family planning services for about 4 million people, and 1.6 million, or 40%, of these get their Title X-funded care at Planned Parenthood clinics, according to the Guttmacher Institute, a women's reproductive health policy think tank.

Trump's 2018 and 2019 budget blueprints called for banning all federal funding to Planned Parenthood.

The consequences of the executive order could be far-reaching for other safety-net clinics and doctors. Guttmacher has projected that nationwide, federally qualified health centers would have to take on about 2 million extra patients for contraceptive services even though only 6 in 10 clinics served at least 10 people seeking this care in 2015.

On average, a Planned Parenthood clinic takes care of nearly 3,000 contraceptive patients per year while a federally qualified health center typically serves about 320 a year, Guttmacher found. Community health centers in 27 states would have to double the number of contraceptive patients they treat; in nine states they would have to at least triple their caseload.

The administration has been transforming the longtime bipartisan program quickly, starting earlier this year when officials shrank the three-year funding cycles for Title X grants to just one year. That means the entire network of current grantees will need to apply to keep their funding this year and in subsequent years.

The Office of Population Affairs, an HHS agency that administers the grants, also delayed the funding announcement for Title X applicants until late February, three months after it was expected.

The funding announcement appeared to steer the focus away from contraceptives by expanding eligibility to applicants who offer services like "natural family planning methods" or "fertility awareness."

Meanwhile, conservatives on Capitol Hill have been lobbying HHS to implement this ban.

Earlier this month, Reps. Ron Estes (R-Kan.), Vicky Hartzler (R-Mo.) and Chris Smith (R-N.J.) sought their colleagues' signatures for a letter to HHS Secretary Alex Azar urging him to bar any provider that offers abortion services from receiving Title X family planning grants.

"To ensure that the federally funded family planning services offered by Title X grant recipients are unquestionably separate and distinct from abortion, Title X service sites should be physically, as well as financially, separate from facilities that provide abortion," the lawmakers said in the letter.

The letter also asked Azar to eliminate abortion referrals from the program's grantee requirements. Current regulations mandate that abortion referrals must be included among the alternatives the providers offer pregnant women.

The lawmakers specifically called out Planned Parenthood by citing a recent Government Accountability Office report's findings that between 2013 and 2015 the organization received $60 million annually in federal funds for women's healthcare. They referenced a tweet from retiring Planned Parenthood President Cecile Richards to note that the organization believes abortion to be a necessary service.

"It is time for the Title X funding stream for Planned Parenthood to be turned off," they wrote.

An edited version of this story can also be found in Modern Healthcare's April 30 print edition.