The Ninth Circuit Thursday allowed the Trump administration’s domestic gag rule to go into effect—putting women of color, young women and low-income women at risk. The policy prohibits doctors at federally funded reproductive healthcare clinics from discussing abortion with their patients or making referrals to abortion providers, even if a woman’s health or life is at risk if a pregnancy continues.
Thursday’s devastating ruling came one day after doctors condemned the Trump administration’s policy at a House Oversight and Investigations Subcommittee hearing.
“These rule changes force providers into an impossible choice,” Title X expert Dr. Monica McLemore, an assistant professor at the collaborative research group Advancing New Standards in Reproductive Health at University of California San Francisco, said at Wednesday’s hearing. “Will we care for the pregnant person in front of us and make a requested referral for abortion related services, or will we accept funds allowing us to care for thousands of others?”
Title X is the nation’s only dedicated federally funded family planning program serving low-income people. It provides essential health care and family planning care to more than 4 million people across the U.S. every year.
In 2017, roughly 4,000 clinics received Title X funds that accounted for 19 percent of their revenue, according to the Department of Health and Human Services. Planned Parenthood receives about $60 million a year in Title X funding, but has said they will not accept these funds under the new rules. On Thursday, they announced that they have “limited emergency funds” that will allow clinics to continue to care for patients and they have vowed to appeal ruling.
“Planned Parenthood will not stand for this attack on millions of people across the country,” PP President Dr. Leana Wen said in a statement. “We will be immediately seeking emergency relief from the Court of Appeals. Planned Parenthood will not let the government censor our doctors and nurses from informing patients where and how they can access health care.”
Attacks on Title X are nothing new: health care providers who rely on the program have experienced funding cuts for years that have caused more than one million people to lose access to care. But the Trump administration’s gag rule completely undermines the program—and is particularly harmful to low-income women and women of color.
According to the American College of Obstetricians and Gynecologists (ACOG), the new rules restrict providers from delivering essential and medically accurate information to their patients and put more than 40 percent of Title X patients at risk of losing access to critical primary and preventive care services. People of color comprise half of all people served at such clinics.
ACOG is one of many leading medical organizations that oppose the new rules, including the American Medical Association (AMA), the American Nurses Association, the American Academy of Pediatrics, the American College of Nurse-Midwives and the American College of Physicians.
The AMA filed the lawsuit to block implementation of the rules that went before the Ninth Circuit, asserting that Trump’s policy would “decimate the Title X program” by imposing a “gag rule” on physicians and re-directing funds away from evidence-based contraception methods to non-medical family planning services such as abstinence and “fertility awareness.” The AMA states that they “strongly oppose any government interference in the exam room, especially legislation or regulations that attempt to dictate the content of physicians’ conversations with their patients.”
It was a sentiment echoed Wednesday—and by many doctors and medical professionals who have been speaking out about the Trump administration’s gag rule since it was first proposed.
“The federal government is telling me and other providers what we can and cannot say to our patients. It is telling my patients what they can and cannot hear from their doctors. It is ordering me to deprive my patients of information they need, even if they request it,” Dr. Jamila Perritt, an OB/GYN and abortion provider in Washington, D.C., and a fellow with Physicians for Reproductive Health, testified Wednesday. “It is an attempt to strip from my patients their basic human rights.”
