HHS late Tuesday released proposed regulations to block Planned Parenthood and other abortion providers from receiving Title X family planning funds, as well as ban any abortion referrals.
Title X family planning participants could still offer "non-directive" counseling about abortion, which according to the rule means that a provider can offer a list of "licensed, qualified, comprehensive health service providers" that could include abortion care to a woman who has decided on an abortion and asks for recommendations.
President Donald Trump announced the new proposed rule Tuesday evening at a gala fundraiser by the anti-abortion Susan B. Anthony List, where he was introduced by the organization's president, Marjorie Dannenfelser, who called him "the most pro-life president in history."
The proposal represents a fundamental change to the Title X family planning program. Current regulations allow Title X clinics to refer patients to abortion providers on request, but HHS said in the proposed rule that the provision is inconsistent with other aspects of the law, "premised on an erroneous notion that the statute is neutral on the question whether Title X funds may be used to encourage or promote abortion as a method of family planning, and violative of federal healthcare conscience statutes."
The proposed rule would also tighten reporting requirements for Title X grantees. Under the new regulations, grantees would have to show HHS that their provider networks receiving the grant money comply with the rules.
Clinics receiving Title X funds also would be required to keep records of "specific actions taken" to encourage family participation in a minor seeking family planning services unless it's suspected that the minor is a victim of sexual abuse.
Other proposals within the rule would let people whose employer-sponsored insurance plans don't cover contraception because of their employer's religious beliefs receive coverage under Title X. They home in on issues of sex trafficking, child abuse, molestation, incest, rape and domestic violence by mandating annual training for grantee clinics and setting up "site-specific protocol" to protect victims.
The first round of grant applications for Title X are due this week. The American Civil Liberties Union and National Family Planning & Reproductive Health Association sued HHS this month over tweaks to funding criteria made earlier this year. The groups asked a federal court in Washington to block HHS from using the new criteria to award this year's grants. Planned Parenthood of Wisconsin, Planned Parenthood of Greater Ohio and the Planned Parenthood Association of Utah filed a separate, companion lawsuit in the same court. Last week, 20 state attorneys general led by California Attorney General Xavier Becerra filed an amicus brief in support of the lawsuit.
Once the rule takes effect, the executive order's consequences will drastically hit the safety-net clinics and doctors. The Guttmacher Institute projected that federally qualified health centers would have to take on about 2 million extra patients across the country 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.
Trump made it clear at Tuesday's event that the administration will keep moving on the anti-abortion front, touting the number of federal judges he has appointed and urging voters to turn out for 2018 midterms to ban late-term abortions.
"We are also seeking passage of the 20-week abortion bill which would end the painful late-term abortions nationwide," Trump said, taking aim at Sens. Jon Tester (D-Mont.), Claire McCaskill (D-Mo.), Heidi Heitkamp (D-N.D.) and Debbie Stabenow (D-Mich.) for opposing the bill that passed in the House of Representatives but failed to meet the 60-vote threshhold.
The Susan B. Anthony List's Dannenfelser said for 2018 the organization plans to double the number of voters reached in 2016 through the grassroots "get out the vote" effort. For the 2016 election, Dannenfelser said the group reached 1 million voters.
