By Nicole Rojas
Finding great health care services in the United States can be a daunting task, made even more difficult when resources are limited. For the four million Americans using Title X, a federal program that provides access to family planning and preventive health services, things are about to get more complicated.
On February 22, the Trump administration proposed a new rule to Title X, which would cut funding for birth control, STD prevention, and cancer screenings to any organization that provides or refers patients to abortions, NPR reported. The administration claims the updated rule will “ensure a holistic and health-centered approach, safeguarding the short- and long-term family planning needs” of more patients under the Title X program.
But Dr. Leana Wen, the president of Planned Parenthood, is calling their bluff.
“What the Trump administration is doing is dismantling Title X and taking away health care from millions of people,” she tells MTV News. “Specifically, the administration is putting a gag on doctors, saying that patients coming into Title X clinics now cannot get a referral for abortion care, even if they ask for it.” Such a rule would also drastically affect the millions of low-income Americans who depend on Title X for their reproductive healthcare across the board. However, abortion care specifically has been a longtime point of contention for many politicians, even though the Supreme Court ruled in favor of its legality in 1973 with their decision on Roe V. Wade.
According to the Guttmacher Institute, 23.7 percent of women in the United States will have an abortion by the age of 45, though the number of abortions in the U.S. have dropped significantly — down 25 percent between 2008 and 2014. That decrease hasn’t stopped lawmakers in 13 states from introducing restrictive bans on abortion after 6 weeks, which is often the earliest that a person can even realize they’re pregnant; according to experts, these types of laws are being introduced in an effort to overturn Roe.
Instead of referring patients for abortions, Title X providers would only be allowed to provide patients who ask for a referral with a list of comprehensive primary health care providers, according to the Los Angeles Times. The rule mandates that some of the facilities listed, “but not the majority,” can provide abortions. Title X providers would be prohibited from saying which facilities offer abortions.
In its annual report, Planned Parenthood said abortions represented just 4 percent of the services it provided, but the rule change would block funding entirely. The Trump administration is also pushing Title X providers to prove they are not using federal money on abortions — but that provision is already banned by Congress. And given that the bulk of Planned Parenthood’s services have nothing to do with abortion, Dr. Wen sees the gag as indicative of a larger, equally damaging issue: that the new law would force doctors into breaking another healthcare law.
She notes that the rules are essentially censoring doctors and forcing them to withhold vital information from patients. “Not being able to discuss and refer our patients for abortion care is forcing doctors to censor what we can and cannot say to our patients,” she said. “It violates the law as passed by Congress, which specifically states that doctors must provide the full range of options to our patients.”
Unless a judge rules against the Trump administration’s new rule, it will go into effect in May. Planned Parenthood filed a lawsuit against the new rule on March 5, joining similar claims made by the American Medical Association, the Center for Reproductive Rights, the American Civil Liberties Union and a coalition of nearly two dozen states. And she’s hopeful that young people will join in on the fight, not least of all because 63 percent of patients who rely on health centers that use Title X funding are under the age of 30.
To that effect, the organization also launched the Protect X campaign, which aims to educate Americans around the country and to mobilize them against the administration’s efforts to diminish access to health care services. Given these proposed changes to Title X would largely affect uninsured patients with limited resources, such as young people who need care without using their parents’ insurance, this action is especially urgent.
The Trump administration also hopes to use the new rule to tackle family communication. One new requirement in the gag rule would force staff at Title X health centers to document specific actions taken to encourage minors to involve their family in their health care decisions.
“Planned Parenthood health centers already encourage family involvement, but there are cases such as abuse, LGBTQ discrimination, or simply a desire for pregnancy where young people may simply choose not to,” Dr. Wen said. “Imposing these additional requirements may interfere with the doctor-patient relationship and deter young people from seeking healthcare altogether.”
Lower-income Americans, particularly people of color and Latinx people, will also be affected by the new rule. More than a third of the patients who rely on Title X are Hispanic or Latinx and 13 percent have limited proficiency in English, meaning the new rule would add yet another layer of discrimination, Dr. Wen says.
“Many of these people already face the greatest barriers to care and the changes to the Title X program will only worsen existing health care disparities. This is an attack, again, by the Trump administration on those who are the most vulnerable,” she says. “It’s people of color. It’s families with low income who are struggling to make ends meet. It’s immigrants. It’s LGBTQ people. And this is one more attack to take away health care from people who already face the greatest barriers to care.”
“Let me say it this way,” Dr. Wen adds. “As a doctor, I know that keeping people unhealthy is a tool of oppression and stigmatizing women’s health care is a tool of misogyny. What these anti-women’s health politicians are doing … it’s not about health care. It’s about politics, and it’s about power and control over women’s bodies.”
Additional reporting by Ella Cerón