Some state governments have promised to make up the lost federal funding. Governors in Hawaii, Illinois, New York, Oregon and Washington have said their states would not participate in Title X under the new rule. Legislatures in Massachusetts and Maryland have passed laws that essentially have the same effect.
Earlier this month, the Department of Health and Human Services posted an explanation of the timeline and details of the new policy, saying that it is “not a gag rule.”
“Health professionals are free to provide nondirective pregnancy counseling, including counseling on abortion, and are not prohibited in any way from providing medically necessary information to clients,” the department said. “The Final Rule does NOT include the 1988 Regulation’s prohibition on counseling on abortion — characterized by some as a ‘gag rule’ — but neither does it retain the mandate that all grantees MUST counsel on, and refer for, abortion.”
The department said that “while Title X providers are prohibited from referring for abortion as a method of family planning, referral for abortion because of an emergency medical situation is not prohibited.”
It said providers may give pregnant women “a list of comprehensive health care providers (including prenatal care providers), including some (but not the majority) who perform abortion as part of a comprehensive health care practice. However, this list cannot serve as a referral for, nor identify those who provide abortion — and Title X providers cannot indicate those on the list who provide abortion.”
Because clinics receiving Title X money will no longer have to counsel women on all reproductive options, including abortion, the new rule may make faith-based providers and others that oppose abortion eligible for funding — a change that could significantly alter the guidance patients receive.
Organizations receiving Title X funds will still be able to perform abortions but will have to do so in a separate facility from their other operations and adhere to the new requirement that they not refer patients to it. Clinics have been prohibited for years from using federal money to finance abortion services. The new rule goes a step further by ordering them to keep separate books for their abortion operations. Those changes are expected to take effect in 2020.
Planned Parenthood is not the only provider that has bridled at the new rule. In Maine, the only Title X recipient, Maine Family Planning, has decided to withdraw from the program, but has said that, for now, it will not close any of its 18 clinics.