The Trump administration’s actions undermine our health

Keeping America healthy is complicated; and over the past two years, the Trump administration has made it much more difficult. From attacking the Affordable Care Act and rolling back environmental regulations, to cutting social support programs, the White House has launched an assault on public health. The administration is waging a coordinated effort to attack reproductive health care: Extreme bans on abortion care are passing across the country as the president stacks the courts with judges with the goal of overturning Roe v. Wade. 

One of the Trump administration’s latest casualties is Title X. Enacted in 1970, Title X is a public health program that provides affordable birth control and reproductive health care and prevention services. Its goal is to ensure patients have access to the highest quality of reproductive and preventive health care regardless of income or economic status. This includes prevention and treatment for sexually transmitted diseases, cancer screenings and birth control, but has never included funding for abortion care.

Yet, the Trump administration announced in February that it will gag health professionals who treat Title X patients by barring them from even referring those patients for abortion care. Regulating what a doctor can say to a patient in the exam room would be unconscionable for any other aspect of health care — can you imagine if doctors could not tell their patients with diabetes how to get insulin? The gag rule would affect Planned Parenthood as well as other health care providers, and have impacts far beyond reproductive health.

Earlier this year, Planned Parenthood joined the American Medical Association to sue the administration over the Title X gag rule, and a district court issued a preliminary injunction to block the rule from taking place as scheduled. A few weeks ago, in a blow to the 4 million people who rely on Title X health centers for care, a federal appeals court stayed the district court ruling, giving the administration the green light to enforce its dangerous gag rule. 

Then, last week, the appeals court voted to rehear the stay en blanc, blocking the gag rule anew, and providing much-needed emergency relief to millions of people who access birth control and other reproductive health services through the program. While this ruling temporarily protects patients’ access to health care, the legal battle is far from over. The stakes are simply too high for us to stop here. It only reinforces the need for Congress to act to block the Title X gag rule — as we cannot only rely on the courts to protect people’s access to basic health care.  

The Title X gag rule will affect many aspects of our health. It will also impact how the U.S. is tackling any health problem that affects women, men, youth, and families. For example, more than 130 people in the U.S. die each day as a result of opioid overdose. Screening for opioid use and referral for patients with addiction are essential to tackling the epidemic, and Title X helps fund many of the health facilities and providers that offer screening and treatment services.  

Planned Parenthood health centers across the country screen for risk factors including substance use disorder, provide referrals for addiction treatment if appropriate, and many carry the opioid antidote, naloxone; some even prescribe it to people at risk of overdose. A national epidemic of this scale requires “all hands on deck” for diagnosis, treatment and prevention. Taking away any critical component of the public health system can only make things worse. 

In his State of the Union address earlier this year, President Trump announced what he called a bold new initiative to end new HIV transmissions in 10 years. However, Title X funding is a cornerstone of existing anti-HIV efforts. 

In 2017, Title X service sites performed 1.2 million HIV tests (more than 740,000 tests were performed at Planned Parenthood health centers alone). For many patients, the care received at Title X health centers is the only care they will receive during a given year, and consequently their only opportunity to get HIV screening and counseling. How can we tackle HIV/AIDS in a decade without this critical program? 

Over the next few weeks, we have an opportunity to flip the script. The federal court’s devastating ruling came just days after our champions in the House passed an appropriations bill that includes language to protect Title X and helps ensure access to birth control and cancer screenings for millions of people — regardless of where they live or how much money they make. We now look to the Senate to approve the same protection passed in the House. 

We know that when we make our voices heard, we win. Now is the time for the Senate to stand with patients and protect care for those who need it most. Call your Senators and tell them to protect Title X.

There is a real need and opportunity right now to make inroads against our nation’s leading health challenges. But by undermining public health policies and programs that work, the Trump administration is putting our health at risk. We must stand together to send a clear message to the administration: Health care is a right, not a privilege reserved for just those who can afford it.

Dr. Georges C. Benjamin is executive director of the American Public Health Association. Dr. Leana S. Wen is president of Planned Parenthood Federation of America and Planned Parenthood Action Fund.

Tags Donald Trump Health Health care Title X Women's health

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