Access to quality health care took a direct hit with the release of a new, finalized rule governing the Title X Family Planning Program — the nation’s only dedicated federal source of funding providing family planning services and supplies to low-income people.
The rule, which is also referred to as the “domestic gag rule,” blocks providers from giving patients full information. Issued by the Trump administration, the rule will go into effect in early May, unless the courts intervene. This rule will fundamentally impede people’s power to decide if, when, and under what circumstances to get pregnant and have a child. It is a damaging attack on a woman’s ability to access quality information and services, which includes the full spectrum of reproductive health care. The rule is unethical, and firmly grounded in political ideology rather than evidence.
The Title X Family Planning Program has kept those who depend on the program health for nearly 50 years, the gold standard for patient-centered family planning care. In addition to contraceptive services and supplies, Title X clinics provide screenings for sexually transmitted infections, Pap tests, cancer screenings, and more.
In rural and other low resource settings, these clinics can often be the only source of care for those that depend on them. In fact, for more than half of all women getting contraception at Title X clinics, the visit was the only health-care provider they saw all year and — prior to the rule — honest guidance with regard to her legal health options.
The final rule would limit the care people who depend on Title X will receive. It would prohibit the program from funding high-quality, affordable contraceptive services at publicly funded health centers that also offer abortion services, unless those services are offered at a physically separate site.
In addition, the rule allows health providers who work at sites that receive Title X funds to not provide information about abortion services alongside other pregnancy options and effectively bans providers from referring patients for abortion. The rule also paves the way for Title X funding to go to sites that offer only abstinence counseling and fertility awareness based methods (commonly referred to as the rhythm method) rather than a broad range of FDA-approved contraceptive methods.
This attack on the Title X program demonstrates a complete lack of regard for the critical importance of birth control access in people’s lives, and the sanctity of the relationship between patients and providers. Not only is this out of step with the evidence, it is out of step with the public will. More than 75 percent of people in the United States — across political party lines — support Title X services in their current form.
No provider should be restricted from providing ethical, quality care, which includes the full spectrum of reproductive health options, to those most in need. But tragically, this rule does just that. That is why 19 provider groups have spoken out in opposition to this rule. Because many providers will understandably choose to not forsake their professional obligations to provide quality and patient-centered care, it is likely that many of these publicly funded health centers will be forced to close their doors or otherwise limit the services they provide their clients.
The final rule will limit people’s ability to access the care they need and deserve, and further disadvantage people who are forced to rely on system that cannot meet their needs with regard to family planning. In the United States, more than 19 million women eligible for publicly funded contraception live in contraceptive deserts — meaning they do not have reasonable access to the full range of contraceptive methods. The final rule will only exacerbate these grave challenges to accessing basic health care for millions of people in need.
We need to do better. We must continue to remind policy makers and others that reproductive health care is simply basic health care. More than 80 percent of people in the United States agree. We can also share our stories about how access to reproductive health care has helped us live life on our own terms.
This is not the first time our access to reproductive health options has been attacked. But if we unite, and raise our collective voice, we can move one step closer towards it being the last.
Ginny Ehrlich is the CEO of Power to Decide, which is a private, non-profit organization that works to ensure all women have the power to decide if, when, and under what circumstances to get pregnant.