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State providers brace for Title X ‘gag rule’ over abortion funding

  • Supporters of state funding for Planned Parenthood listen Wednesday, Aug. 5, 2015, in Concord, N.H. The Republican-led Executive Council has rejected roughly 650,000 in state funding for Planned Parenthood to provide health services such as contraception, STD testing and counseling. The debate Wednesday comes amid national scrutiny over Planned Parenthood's policies regarding voluntary fetal tissue donation for medical research. (AP Photo/Jim Cole) Jim Cole



Monitor staff
Tuesday, May 22, 2018

Exactly when the White House makes an expected announcement to pare back funding from abortion clinics remains unclear. But some New Hampshire reproductive health providers are already sounding the alarm.

On Friday, news reports swirled that the Trump administration will propose a rule to withhold “Title X” federal funding for healthcare organizations that perform abortions – as well as those who make referrals. Under the rule, clinics whose doctors provided recommendations of abortion services could lose their funding, while those that already do would be cut off unless they stopped.

Conservatives and anti-abortion advocates have hailed the move as a long-overdue measure to detach federal dollars from the practice of abortion, one that fulfilled a key campaign promise by the president and could energize Republicans ahead of mid-term elections.

But Planned Parenthood, one of the proposal’s prime targets, has another term for it: a “gag rule.” If implemented, representatives of the state chapter said Friday, the rule could hurt women’s health services that aren’t directly related to abortion, reducing access and hurting low-income populations.

Sabrina Dunlap, Vice President for Public Policy in the New Hampshire, called the rule “a cruel policy that would be disastrous for the populations most in need of basic health care.”

“Under the proposed domestic gag rule, the care that Granite Staters need, such as birth control, cancer screenings, STD testing and treatment, or well person exams, will be jeopardized,” Dunlap said.

At issue is a 1970 federal grant program – Title X – the first and only dedicated government funding vehicle for family planning services. For decades, Planned Parenthood has made use of the funds to expand its own services, but the money has also flowed to hospitals, clinics and other women’s health programs.

In New Hampshire, the money has helped prop up each of the five Planned Parenthood clinics across the state, as well as other organizations such as the Concord Hospital Family Health Center and the Coos County Family Health Center in Berlin. For Planned Parenthood, the grants represent about a third of New Hampshire clinics’ operating budgets, Dunlap said Friday.

But for as long as the grant program has been in effect, it’s attracted debate. In creating the program, the Congress of 1970 added a legal firewall: organizations could not use Title X funds “in programs where abortion is a method of family planning.” Those services, if provided, would need to be funded separately, the act stipulated. Other services, like contraceptives and sexual disease testing, could receive the funds.

Despite the firewall, anti-abortion proponents have argued that federal money should still not support entities that carry out the practice. The Trump administration’s proposed rule, reported by the New York Times on Thursday, would yank money from clinics if abortions were carried out anywhere.

Conservatives in the state welcomed the reports.

“The proposed (Health and Human Services) rule is good news,” said Shannon McGinley, executive director of Cornerstone Action. “We welcome any step that respects the conscience rights of people who choose not to fund abortion directly or indirectly.”

McGinley said funds could still go to reproductive care from clinics that don’t provide abortions. And she rejected the premise of the legal firewall, maintaining that any government support to Planned Parenthood ultimately benefited its procedures.

“It’s long past time to recognize that any tax dollars going to abortion providers, even for non-abortion services, help pay the overhead for procedures that directly and intentionally terminate human life,” she said. “There are no firewalls.”

Dunlap and other health care representatives, meanwhile, warn the move could carry sharp side effects. Despite the rule change, Planned Parenthood does not plan to cease its abortion practices; in a press call Friday, Dawn Laguens, Executive Vice President of the national organization, said they would “never turn our back on providing the full range of reproductive health care.” Dunlap echoed the sentiment.

Absent a drastic restructuring, Planned Parenthood would likely lose its Title X funding. Picking up the slack would be community health organizations, who could use their own federal funds to cover contraceptive and reproductive care. But opponents say covering all the gaps could be impossible.

A 2017 report by the Guttmacher Institute, a left-leaning reproductive health think tank, found that a loss in Title X funding for Planned Parenthood would on average require federally qualified health centers to nearly double their intake to plug the hole – a 116 percent increase. In New Hampshire, that increase would be 67 percent, Kinsey Hasstedt, Senior Policy Manager for the institute, said Friday.

Opponents say those health centers are not presently as well-equipped as Planned Parenthood clinics, meaning more sophisticated forms of birth control such as long term interuterine devices might be less available to patients.

For the Concord-based Equality Health Center, which provides reproductive health services and abortions, losing Title X money would not be a major hit financially; the group receives just $80,000 a year, less than 10 percent of its budget. But without that extra federal money, the Center couldn’t keep down the costs of its services, which could have severe knock-on effects for patients, Executive Director Dalia Vidunas said Friday.

“It will definitely affect local independent providers tremendously,” she said of the proposed rule.

How – and whether – that rule goes into effect remains to be seen. It will likely need to endure a public comment period through the federal Health and Human Services department, a process that could take months. And while release of the final version is expected soon, the administration has released only broad outlines so far.

Hasstedt, who authored the Guttmacher report, said without seeing the final language of the rule, predicting its exact effects is difficult. But she added it would be a mistake to see the move through the lens of its effects on Planned Parenthood.

“It is quite plainly framed as an attack on Planned Parenthood, but really the impact would be felt far outside,” she said.

Still, the proposal didn’t appear in a vacuum. Opponents of abortion, long bothered by the Title X funding, have clamored for the rule change for years.

Jennifer Robidoux, president of New Hampshire Right to Life, hailed the move as validation.

“President Trump is keeping his promise to defund Planned Parenthood. Will New Hampshire? We urge our state to follow President Trump’s lead and not give taxpayer money to abortion facilities, including Planned Parenthood,” she said in a statement.

“Taxpayers should not be forced to subsidize abortions,” Robidoux added.

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)