Every year, nearly 4 million people rely on the Title X family planning program for birth control, STI testing and treatment, and cancer screenings, among other things. For anyone unfamiliar, this federal grant program funds clinics to help guarantee access to a variety of family planning and preventive health services for primarily low-income people or those who are uninsured.
When people are able to get the birth control that best fits their needs, they’re less likely to have an unintended pregnancy. And Title X clinics and the health care providers they employ are more likely to offer a full range of contraceptive options than public clinics that don’t receive Title X funds, according to a 2017 report by the Guttmacher Institute. So it should come as little surprise that Title X clinics were estimated to help prevent over 800,000 unintended pregnancies a year.
At this point you might wonder, “But why fix what isn’t broken?” Well, these rule changes represent yet another part of this administration’s wide-reaching strategy to dismantle access to reproductive health care, namely abortion services.
When reading through the proposed changes (which you can read in full here), many of the them sound harmless. Who wouldn’t want a program to “ensure a holistic and health-centered approach” to a person’s family planning needs, as the U.S. Department of Health & Human Services (HHS) announcement read? But as with so many of the devastating policies that have been promoted by the Trump-Pence administration, the devil is in the details.
Depending on how the rules are interpreted and enforced, the result could be the closure of family planning clinics or a greatly reduced ability for clinics to see low-income patients. This is especially worrisome because health centers like Planned Parenthood (which would almost certainly be barred from participating in Title X) are the sole providers of family planning services in 33 percent of the counties served by Title X clinics.
Because some of the rule changes appear to use intentionally vague language, it will be difficult to know exactly how they might affect access to reproductive health care until they are actually implemented. But the medical community is worried: Organizations like the American Medical Association (AMA) and the American Congress of Obstetricians and Gynecologists (ACOG) have issued statements condemning the proposed changes.
That’s why, as an abortion provider and women’s health advocate, I wanted to read between the lines to see what really might be at stake. Let’s unpack a few of the most troubling changes and what they could mean for people seeking reproductive health care.
This sounds like a deceptive way of saying that your health care provider could withhold information about safe, legal, evidence-based treatment when you are seeking options and/or counseling for an unintended pregnancy.
While existing law already protects the conscience rights of health care providers to refuse to provide abortion, it is clearly unethical to refuse to give a referral so that people can get the care they need elsewhere, even if you as a physician cannot offer it.