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White House Proposes Restrictions on Family Planning Clinics

<ѻý class="mpt-content-deck">— Rule would reinstitute a mandate first promulgated under President Reagan
MedpageToday

WASHINGTON — The Trump administration has moved closer to issuing a regulation that would reinstate a restriction first issued during the Reagan administration intended to prevent federal funds from being used even indirectly to support clinics that provide abortions.

The proposed rule, which the White House for review on Thursday, would require that organizations that provide abortions as well as other health services, including family planning, house the abortion services in a separate facility with separate personnel and finances, according to . It would apply to clinics that receive money from the federal government's $287-million .

“This important proposal would ensure compliance with the program’s existing statutory prohibition on funding programs in which abortion is a method of family planning,” the White House said in a press release issued Friday evening. “The new proposed rule would not cut funds from the Title X program. Instead, it would ensure that taxpayers do not indirectly fund abortions,” the release added.

However, “contrary to recent media reports, HHS’s proposal does not include the so-called ‘gag rule’ on counseling about abortion” that was part of a Title X regulation issued in 1988 by the Reagan administration, the White House said. That regulation was but never fully implemented. It was by the Clinton administration.

Officials at Planned Parenthood, which receives the largest share of Title X funds of any organization ($50 to $60 million, according to ), said they wouldn't comply with the physical separation requirement.

"It is really inconceivable and also unwarranted that a safe, legal medical procedure that is part of women's reproductive health should have to be stigmatized and put off to the side in some kind of separate facility from where people go to get their healthcare," said Dawn Laguens, executive vice president of the Planned Parenthood Federation of America, on a phone call with reporters Friday.

"Planned Parenthood is not planning to do anything that would indicate or show or communicate that the full range of women's reproductive health services aren't necessary, aren't important, or aren't legal in this country."

In addition, the proposed rule "really removes the guarantee that patients are getting full and accurate information from their doctor," she added. "This is a far-reaching attack and attempt to take away women's basic rights and reproductive rights, period."

The American College of Obstetricians and Gynecologists (ACOG) also expressed opposition to the proposed rule. “Anticipated changes to Title X pose an egregious intrusion in the patient-provider relationship,” Hal Lawrence, MD, executive vice president and CEO of ACOG, said in a statement. “Restricting the Title X program would limit access to preventive care for four million Americans annually. Contraceptive care is not an insignificant or minor component to women’s healthcare. It’s routine and necessary preventive care.”

But others praised the idea. "The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) applauds President Trump's common sense clarification of the original purpose of Title X, which explicitly did not support pushing abortion as a method of family planning," said Donna Harrison, MD, AAPLOG's executive director, in a statement.

"Under previous administrations, the intent of Title X was contorted and circumvented in order to allow Planned Parenthood to pay for everything up to the point of the actual abortion, including pressuring women to have abortions in their counseling," said Harrison. "The Trump administration action corrects this horrendous perversion of the law and restores Title X funds to real healthcare facilities, instead of abortion mills. AAPLOG applauds this clarification."

At least one group said the proposed regulation doesn't go far enough. "The federal government has an obligation to not fund abortions with taxpayer dollars," Monica Burke, a research assistant at the Heritage Foundation, a right-leaning think tank here, said in a statement. "Requiring organizations like Planned Parenthood to maintain a strict financial and physical separation between taxpayer-funded Title X activities and abortions reinforces this commitment to the American public."

"But Americans should remember that more must be done to unwind federal funds from the abortion industry," she continued. "Planned Parenthood, the nation's largest abortion provider, received more than $1.5 billion in taxpayer funds from 2013 to 2015. Much of this money came from the Medicaid public health program. Congress should make it a priority to stop abortion clinics from receiving Medicaid funds and instead direct that money to the thousands of healthcare centers that provide healthcare for women and families without any involvement in the abortion industry."

Planned Parenthood serves 41% of the 4 million patients -- mostly low-income and uninsured women -- who benefit from the Title X program, according to the organization. The National Association of Community Health Centers (NACHC) has previously said that it would prefer that Planned Parenthood continue to serve the patients they're currently serving rather than having those patients come to community health clinics. The Planned Parenthood clinics "are located in communities where care is scarce and needs to be continued," Dan Hawkins, senior vice president for public policy and research at NACHC, told ѻý.