Biden administration to reverse Trump abortion rules for Title X

The Biden administration has officially begun the process of reversing a series of Trump-era family planning funding rules that has blocked abortion providers like Planned Parenthood from receiving federal dollars. Critics of the former administration’s policy referred to the regulations as a “gag order” on abortion.

The 71-page proposal published Wednesday morning by the U.S. Department of Health and Human Services would revoke the entirety of the Trump administration’s 2019 changes to Title X, the marquee federal program dedicated to providing birth control to low-income women. The current rules, implemented in March 2019, prohibited providers offering or referring abortion services to patients from participating in the federal program, which funds services like birth control and screenings for sexually transmitted diseases and infections. Since its debut in 1970, Title X funds have never been used to subsidize or pay for abortion services.

The 71-page proposal detailed the negative impact of the 2019 rule change, writing that it “undermined the public health of the population the program is meant to serve.”

“Ultimately, continued enforcement of the 2019 rule raises the possibility of a two-tiered healthcare system in which those with insurance and full access to healthcare receive full medical information and referrals, while low-income populations with fewer opportunities for care are relegated to inferior access,” said the rule proposal.

The current rules stemmed from the Trump administration’s promise to “defund Planned Parenthood.” The rule change prompted Planned Parenthood to exit the program, forgoing an estimated $60 million. In 2018, more than four million people relied on Title X for health care services, 41% of whom received services at Planned Parenthood, according to the health clinic.

Wednesday’s proposal offered a glimpse into how the current Title X regulations have impacted reproductive health among low-income people. According to the proposal, after the current rules were implemented, more than 1,000 Title X service sites closed — about a quarter of all Title X-funded sites. Six states — Hawaii, Maine, Oregon, Utah, Vermont, and Washington — were left with no Title X providers and another six states — Alaska, Connecticut, Massachusetts, Minnesota, New Hampshire, and New York — only had Title X-funded providers on a “very limited basis,” according to HHS’ proposal. In New York, the number of Title X-funded providers dropped to two from 174.

The proposal estimated that the rule change resulted in 181,477 unintended pregnancies.

“Given that so many individuals depend on the Title X program as their primary source of healthcare, this situation creates a widespread public health concern,” said the rule proposal. “The 2019 rule is not in the best interest of public health.”

Planned Parenthood applauded the proposed rule change, and in a statement provided to CBS News, the organization’s chief executive officer Alexis McGill Johnson called Title X a “critical piece of our social safety net.”

“Due to centuries of systemic racism and injustice, the [Trump administration’s Title X change] has disproportionately harmed people of color and people with low incomes, all at a time when access to affordable preventive health care has never been more critical,” Johnson said.

Supporters of the current Title X regulations say that taxpayers who oppose abortion should not be forced to support organizations that provide the procedure, even indirectly.

A 30-day public comment period for the proposed rules will begin on April 15. In March, HHS said in a statement that it hopes to have the proposed rule change finalized early this fall, meaning that clinics that were pushed out of the program could reapply by the end of the year.