The Obama administration on Wednesday moved to protect the future of Title X as congressional Republicans, emboldened by President-elect Trump’s victory, are openly plotting to defund family planning services.
The U.S. Department of Health and Human Services (HHS) finalized a rule clarifying the law and sending a clear message that states cannot deny reproductive health-care providers from receiving federal Title X funds if they provide abortion care. The funds already can’t be used for the procedure. The rule aims to reverse a years-long trend of Republican-majority state legislatures defunding family planning services, disproportionately impacting people with low incomes.
Advocacy groups with a reproductive health-care focus on Wednesday praised the Obama administration’s action.
But Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association, also cautioned that the protections “may only be temporary.”
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“Congressional opponents have made clear their intentions to swiftly reverse all of the recent progress made for women’s health, including blocking these important protections,” Coleman said in a statement. “At a time when the stakes for women’s health could not be higher, the need for a robust family planning safety net has never been greater.”
Republicans in both the U.S. House of Representatives and U.S. Senate already have the Title X rule on the chopping block.
The legislative agenda-setting Senate Republican Policy Committee targeted the “regulation supporting Planned Parenthood” in a recently released outline, “Reining in Obama Regulatory Overreach.”
Senate Republicans indicated they could undo the rule under the Congressional Review Act (CRA), a tool to repeal federal regulations. Federal agencies can’t issue another rule in “substantially the same form,” according to the nonpartisan Congressional Research Service, unless Congress allows them to do so by passing a subsequent law.
Congress can use the CRA through early May on the last six months worth of Obama administration regulations, Senate Republicans said in their outline.
Lawmakers must act “within the first 60 days of the new Congress,” beginning January 3, “on anything that they want to repeal via CRA,” Janel George, director of federal reproductive rights and health for the National Women’s Law Center (NWLC), told Rewire in an email.
The incoming Trump administration could also attempt to roll back the rule under the anti-choice regime set to take over HHS and other federal agencies. Rep. Tom Price (R-GA), Trump’s nominee to lead HHS in the new administration, said in 2012 “there’s not one” woman who can’t afford contraception.
Finalizing the rule “doesn’t completely prevent against [HHS-driven] repeal,” but does ensure procedural steps to do so, adding “some additional protections,” George said in a phone interview.
“If steps are taken to repeal this, I think it would reflect a disconnect about the importance of Title X for access,” she said.
George said Title X provides a “safety net” for “people who are already underserved and impacted by disparities,” including men, adolescents, and many uninsured people in states that did not expand Medicaid under the Affordable Care Act, which congressional Republicans have pledged to repeal under Trump.
HHS could not comment “on the intent or priorities” of future administrations, a spokesperson told Rewire via email. The agency nevertheless “believes that this rule will protect patients who seek Title X services by strengthening access to family planning services in line with the program’s statutory intent.”
“The final rule follows through on overwhelming support conveyed through public comments for protecting access to critical family planning services,” the spokesperson said.
Planned Parenthood Federation of America (PPFA) officials expressed concern about legislative and executive branch attempts to undo the final Title X rule.
“This rule protects birth control, cancer screenings, STI testing and treatment, and other health care for millions of people. Yet this fight is not over,” PPFA President Cecile Richards said in a statement. “We are deeply concerned about the future of health care access in this country with extremists like Mike Pence and Tom Price at the helm.”
Planned Parenthood affiliates care for about 1.5 million patients through Title X—“roughly one third of the more than 4 million people served by the program,” according to the statement.