By Sue Davis
March 15, 2019

The Trump administration’s new rules for Title X, the reproductive health care program serving 4 million low-income women, has two purposes. One has two parts: denying all information about abortion services to patients — the so-called “gag rule” — and defunding Planned Parenthood, which provides 41 percent of Title X patients with a comprehensive range of women’s health needs, including abortion (See Oppose Trump’s Title X changes).

The other is promoting faith-based “crisis pregnancy centers” that offer little or no medical care or postnatal support, while coercing pregnant women to have babies, not abortions.

The second purpose, which has not been covered as much in the corporate media — if at all — is totally in keeping with the Trump administration’s flagrantly right-wing, anti-women/gender-oppressed people, white supremacist agenda.

But the two parts converge in the Trump/Pence wish list — that the revised rules will kick Planned Parenthood out of Title X and lavish funds on anti-abortion facilities.

Title X was passed by Congress in 1970 by the Nixon administration, when providing basic reproductive health care for low-income women was seen as integral to the federal war on poverty — because it would cut welfare payments for poor children!

Trump began planning to restructure Title X when he appointed Diane Foley head of the Office of Population Affairs in the Health and Human Services Department in May 2018 to oversee distribution of Title X funding. Prior to that Foley was president/CEO of Life Network, which, its website states, offers “life-affirming alternatives to abortion” and is an affiliate of CareNet, a large national network of  CPCs.

But this is not the first time an anti-abortion gag rule has been introduced. The Reagan administration rolled out one in 1988, which was repealed in the early 1990s by Congress, though that body lacked the votes to override President George H.W. Bush’s veto. In 1993 President Bill Clinton suspended it with an executive order, and anti-choice rules were formally repealed in 2000.

Designed to open up Title X to anti-abortion facilities

Wording of certain revised HHS regulations exposes its true purpose, reports a March 4 Pacific Standard article — to open the Title X door to CPCs. The revised HHS text reads: “[P]otential grantees and sub-recipients that refuse to provide abortion counseling and referrals will clearly be eligible to participate in the Title X program.” The word “unborn” baby or child is used nine times in the HHS text, but never “fetus”; the word “conscience” is used in the context of abortion 70 times.

The HHS preamble blatantly invites groups previously excluded from Title X funding “due to conscience concerns” to apply. “[It’s] a pretty clear call to those sites to do so,” Kinsey Hasstedt, senior policy manager at the Guttmacher reproductive health research institute, told the Pacific Standard.

Another change, which increases the number of groups eligible to apply for funding, is removing “medically approved” from accepted forms of Title X birth control. That not only weakens standards of care but opens the door to faith-based groups that recommend the often unreliable, so-called “fertility awareness method” based on abstinence.

The current wording states that organizations only offering a single birth control method “may participate” if they are part of a broader network that offers a range of options. But the new wording says facilities “are not required to provide every acceptable and effective family planning method or service.”

As Jessica Marcella, vice president of communications at the National Family Planning and Reproductive Health Association (NFPRHA), pointed out in the article, “[That] could allow for a real shift in the network for providers supported by Title X.” Hasstedt noted that by shifting away from “trusted providers of high-quality care” to new sites with limited services (already infamous for inaccurate information and coercive care) that pressure clients to have children, “[I]t’s really shifting the fundamental purpose and impact of the Title X program in a really troubling way.”

Opposition growing

That’s why dozens of national medical groups, pro-choice legal organizations and advocates, women’s rights groups, pro-choice clergy have come out against the revised regulations. In fact the American Medical Association joined forces with Planned Parenthood on March 5 when they filed a federal lawsuit against changing the Title X regulations.

The AMA based its challenge against the revised rule on two points: “to prevent infringement of the physician/patient relationship and to protect the integrity of Title X.” It denounced the revised rule because  it “blesses biased and incomplete pregnancy counseling where the interests of the patient are no longer paramount” and it “will politicize the practice of medicine and the delivery of health care.” (Time, March 5)

The state of California filed a lawsuit on March 4, while attorneys general in 20 states filed one on March 5. NFPRHA is due to file one soon on behalf of publicly funded family planning providers.

While the current opposition to the rule changes is overwhelmingly legal at this time, it’s obvious that women and other gender-oppressed people — led by people of color, who are the majority of Title X recipients, as well as youth, rural residents, im/migrants, women with disabilities and survivors of domestic abuse — need to start taking to the streets against Title X rule revisions.

Eons of class history have shown that’s the only way basic human rights are won. The right to have an abortion is a basic human right that is at the intersectional root of reproductive justice. Onward to liberation for all gender-oppressed people!