Trump’s HHS Reverses Course on Including Hormonal Birth Control in Title X Grants (Updated)

Last year’s Title X funding announcement introduced grant criteria focused on natural family planning.

[Photo: Hands holding a pack of birth control pills.]
Last August, the Trump administration shortened the grant funding period for Title X from three years to one year. Shutterstock

UPDATE, November 9, 3:36 p.m.: An HHS spokesperson responded to Rewire.News’ questions about how a later rollout of the domestic gag rule would affect 2019 Title X funding. “If a new Title X regulation is finalized, grantees will need to come into compliance with the new regulation according to the timetable within the rule. However, scoring criteria for this competition will not change from that stated in the FOA.”

The U.S. Department of Health and Human Services (HHS) will require those hoping to receive Title X federal family planning grant funding to provide hormonal birth control, reversing itself after last year’s funding announcement sparked lawsuits from providers.

The 2019 Title X Funding Opportunity Announcement (FOA) was released by HHS on Wednesday. According to the announcement, providers must make available a “broad range” of contraceptives, specifying that providers “should include hormonal methods since these are requested most frequently by clients and among the methods shown to be most effective in preventing pregnancy.”

Advocates had braced themselves for a more restrictive FOA for the upcoming year in the midst of a series of hostile anti-choice moves by the Trump administration related to the Title X family planning program. The language reintroducing hormonal contraceptive care came as a welcome respite for providers.

“Re-including references to contraception in this funding announcement suggests that HHS has reflected on our arguments and taken at least some steps to correct its mistakes, though the agency still seems to believe that it is free to depart from controlling regulations in a funding announcement,” said Jessica Marcella, vice president of advocacy and communications for the National Family Planning and Reproductive Health Association (NFPRHA), in a statement.

Last year’s FOA introduced grant criteria focusing on natural family planning, also known as “fertility awareness-based methods,” and abstinence, and de-emphasized evidence-based hormonal contraceptive care prompting NFPRHA, along with the American Civil Liberties Union (ACLU) and Planned Parenthood, to take HHS to court. A federal judge threw out the suit claiming that Planned Parenthood was unlikely to lose funding from the language change.

Trump since taking office in 2016 has filled several key positions at HHS with abstinence-only advocates, most notably Valerie Huber, a senior policy adviser at the Office of the Assistant Secretary of Health (OASH), the office responsible for awarding and administering Title X grants. Previously cited for neglect during her time as a health official for the state of Ohio, Huber has been a driving force behind the abstinence-only education movement, coining the term “sexual risk avoidance.” She was put in charge of writing a new four-year strategic plan for OASH in June.

Last August, the Trump administration shortened the grant funding period for Title X from three years to one year, forcing grantees to reapply for funding annually in a move that reproductive health advocates said would create an undue burden on providers who depend on the funding. “To tax the network with effort semi-annually, rather than follow a customary three-year cycle, makes no sense,” NFPRHA Director of Advocacy and Communications Audrey Sandusky told Rewire.News at the time. “It should be viewed as an attempt to compromise the network and detract from providers’ daily work of ensuring high-quality family planning care to those in need.”

Shortening the grant funding period could open the door for the Trump administration to restrict the funding through its pending domestic gag rule, which would force providers to physically and financially separate their Title X services from their abortion care services, advocates worried. Several advocates who spoke with Rewire.News said they expect HHS to finalize the domestic gag rule sometime in January, though it’s unclear exactly how that rule would apply to fiscal year 2019 grants.

Reproductive health advocates remain on edge as the administration continues its assault on reproductive freedom. “The Trump-Pence administration has made clear where they stand, and they are still trying to kick Planned Parenthood out of Title X, the nation’s program for affordable birth control,” said Dawn Laguens, executive vice president of Planned Parenthood Federation of America in a statement to Rewire.News. “They are using the gag rule to undermine the program and directly attack anyone who can’t afford the rising costs of health care. Since day one, we’ve seen countless attacks on access to birth control and attempts to block preventative care.”

A spokesperson for HHS did not provide comment by the time of publication.