HHS proposes rule to strengthen the federal Title X family planning program

April 20, 2021

The Biden Administration last week began to undo a Trump-era “gag rule” that bans physicians in the Title X program from telling women how they can safely and legally access abortion.

The U.S. Department of Health and Human Services (HHS) has proposed readopting regulations established by HHS in 2000, with modifications that would “strengthen the program and ensure access to equitable, affordable, client-centered, quality family planning services for all clients, especially for low-income clients.”

The California Medical Association (CMA) had strongly opposed Trump’s gag rule since it was first proposed in 2018, arguing that it would interfere with the physician-patient relationship, undermine established medical access and prevent low-income people from accessing the full range of reproductive health care.

The gag rule bar qualified family planning providers that provide abortions or abortion referrals from participating in the $286 million federal Title X family planning program. It also eliminated current requirements that Title X sites offer a broad range of medically approved family planning methods and nondirective pregnancy options counseling; and directed new funds to faith-based and other organizations that promote fertility awareness and abstinence as methods of family planning, rather than the full range of evidence-based family planning methods.

Groups receiving money under the Title X program, which in California serves 1 million low-income women, were already prohibited from performing abortions with those funds. Under Trump’s gag rule, federally-funded family planning clinics were required to maintain a “clear physical and financial separation” between services funded by the government and any organization that provides abortions or abortion referrals.

Established in 1970, Title X is the sole federal program dedicated to funding family planning services for low-income individuals. Title X supports the delivery of family planning and related services including contraception, STD prevention and treatment, pregnancy tests, and life-saving cancer screenings. It plays a vital role in the nation’s public health safety net by ensuring that timely, safe, and evidence-based care is available to women, men and adolescents, regardless of their financial circumstances.


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