More than 1 million low-income Californians could see new barriers to reproductive care under a proposal that the Department of Health and Human Services sent to the White House Friday.
The proposed rule would strip federal funding from family planning clinics that provide abortions or refer patients to places that do. The Associated Press, citing an administration overview of the plan, described it as “scant on details” but resembling a Reagan-era plan to remove such funding.
There are more than 58 clinic sites in the Bay Area receiving such funding, serving more than 155,000 women, men and children, according to Julie Rabinovitz, president and CEO of Essential Access Health, a nonprofit that advocates for the expansion of family planning services.
Tinkering with Title X, a federal grant program that allows low-income people to access subsidized care at clinics run by Planned Parenthood and similar organizations, is at the heart of the administration’s proposal. Funded services range from breast cancer screening to contraceptive care. Title X does not pay for abortions, but it supports clinics that discuss options with their patients or refer them to abortion providers.
The federal program is particularly prominent in California, which accounts for more than 25 percent of all Title X patients nationwide, according to Essential Access Health.
Around the country, about 41 percent of Planned Parenthood’s patients receive subsidized services through Title X, according to the nonprofit. Recipients often do not have access to other health care options.
The proposed rule would issue new guidelines for Title X and require a “physical as well as financial separation” between entities that receive the federal funds and those that provide abortions. This means that a clinic would not receive funding if it shares a space with a clinic that performs abortions or if it provides information to patients about where to receive one.
In San Francisco, Planned Parenthood has two facilities in the Mission. One provides abortion services, while another only offers referrals. Both would be affected under the proposed rule.
The policy was derided as a “gag rule” by abortion rights supporters, a point challenged by the administration, which said counseling about abortion would be OK but not referrals. It’s likely to trigger lawsuits from opponents, and it’s certain to galvanize activists on both sides of the abortion debate going into November’s congressional elections.
The rule would not completely remove Planned Parenthood’s funding, as many clinics also receive money through Medicaid, the federal program that covers low-income Americans.
“In California, Title X is a really important part of enabling family planning clinics to provide a broad range of services to provide the highest quality of care,” said Alina Salganicoff, vice president and director of women’s health policy at the Kaiser Family Foundation. “If they don’t get the Title X funds, it would really strain the ability of the clinics to give women the services they need.”
Marjorie Dannenfelser, president of the Susan B. Anthony List, a group that opposes abortion rights, said in a statement Thursday that this move will “energize” conservative voters heading into the midterm congressional elections this fall.
“We thank President Trump for taking action to disentangle taxpayers from the abortion business,” Dannenfelser said. She added that with this move Trump showed “decisive leadership, delivering on a key promise to pro-life voters who worked so hard to elect him.”
There are several regulatory steps that the rule would need to clear before being implemented, including a mandatory public notice and comment period of at least 30 days.
But reports of the proposal have enraged supporters of women’s reproductive rights.
Dawn Laguens, executive vice president of Planned Parenthood Federation of America, called the new proposal “outrageous” and “dangerous.” California Attorney General Xavier Becerra called the rule “reckless.”
Rabinovitz of Essential Access Health said she is worried about how this rule would affect teen pregnancy rates.
“We’ve made so much progress in the last 20 years in reducing teen pregnancy rates, and we really don’t want to turn back the clocks,” she said. “It’s really about patient choice. Californians should be able to go to any clinic they want to get their health care — and there shouldn’t be any wrong door for them.”
The Associated Press contributed to this report.
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