‘We Are Headed Toward a Public Health Crisis’: Title X Clinics Grapple With Trump’s ‘Gag Rule’

Sept. 11, 2019 (Rewire.News):‘We Are Headed Toward a Public Health Crisis’: Title X Clinics Grapple With Trump’s ‘Gag Rule’, by Erin Heger:

The Trump administration recently introduced a 'gag rule' on recipients of Title X funding, which provides federal money for family planning services to low income individuals hroughout the country. The new rule prohibits clinics receiving Title X funding from referring their patients for abortion care. Clinics that provide abortion services will also have to physically separate abortion and Title X-approved services.

HHS Office of Population Affairs operates Title X by funding “grantees” (health care organizations, state health departments, or non-profits) that oversee the distribution of Title X funds to safety-net clinics and other sites to provide family planning services to low-income, uninsured, and underserved clients.

Because of the recently introduced restrictions, health care organizations and some states are choosing to opt out of receiving Title X funding altogether rather than attempt to comply. The most notable of rejections may be from Planned Parenthood, which announced last month that it was rejecting funding under the new guidelines. The organization's clinics serve 40 percent of the country's Title X patients, and there are concerns that other providers will struggle to take on the resulting predicted increase in patients. According to Guttmacher Institute, there will need to be an estimated 70 percent expansion in clinics' caseloads in order to make up for Planned Parenthood's absence.

Seven states have also opted out, but other states and health care organizations have decided to stay, for fear that clinics they fund will not be able to afford to stay open without the Title X money. Providers in Missouri, for example, are in large part continuing to accept funding.  With previous restrictions on abortions leaving the state with only one abortion clinic, access to reproductive health care is extremely limited as is. "For the majority of Title X patients, their Title X provider is their only source of health care, particularly in small and rural communities," Audrey Sandusky of the National Family Planning and Reproductive Health Association told Rewire.News.

The second part of the gag rule requires that clinics somehow separate out their abortion services from their other functions. This is set to go into effect this coming March, but it's yet to be determined what hoops clinics will have to jump through to remain safely in compliance under these new standards. Many of the providers' plans submitted to the U.S. Department of Health and Human Services have not been approved as of yet. The largest of the Title X administrators, Essential Access Health, has had their plan approved, but its details have not been released.

Sandusky pointed out how low-income individuals already face serious barriers in their lives, and this new restriction makes it even more likely that they will go without care if they cannot go to a Title X provider. "That means they go without cancer screenings, STD testing and treatment, and HIV services. Given the uncertainty that exists across the country, we are headed toward a public health crisis." This certainly seems to be the case.