The Trump administration’s Department of Health and Human Services finalized a rule that will strip health care clinics around the country of federal funding if they refer patients to abortion services. Reproductive rights advocates call it a “gag rule” because it imposes limits on the issues doctors can discuss with their patients if their clinic receives money through Title X, the federal program that funds birth control and reproductive health care. Effectively, the rule achieves a goal Republican lawmakers have doggedly pursued for years: the defunding of Planned Parenthood.
The proposed change, which has yet to be officially published in the Federal Register, will hit patients of Planned Parenthood particularly hard. The organization, which provides health care services to 41 percent of the 4 million patients who receive care through Title X, could effectively be pushed out of the program by the new rule. Advocates fear that the repercussions could be disastrous, with the remaining health care clinics struggling to absorb patients, and low-income women in areas that are currently only served by Planned Parenthood clinics losing access to care altogether.
Doctors and advocates were stricken speaking about the possibilities during a hastily arranged phone call with reporters on Friday afternoon.
“This rule makes it illegal for doctors and nurses to provide information to our patients about how and where they can access abortion care, even if our patients ask for it or if it’s medically necessary,” said Dr. Leana Wen, president of Planned Parenthood. “That means that if you are a woman who goes to a health center that receives public funding, you cannot be referred to abortion care even if your life depends on it. This gag rule is unethical and unconscionable. It’s also unprecedented: our country has never had rule like this that can tell politicians and doctors what we can and cannot say to our patients.
“This is direct interference with the practice of medicine and with our ethical obligation to our patients,” Wen added. She emphasized the fact that the consequences would be disproportionately borne by the most vulnerable: women of color, women in rural communities and low-income families more broadly.
Dr. Niva Lubin-Johnson, president of National Medical Association, expressed concerns specifically about how the policy would impact African-Americans, who make up 22 percent of patients who use Title X-funded facilities nationwide. The rule, she worried, “will undo the progress that the National Medical Association has made reconciling the mistrust that many African-Americans have for the medical system.”
“Demanding that health care providers withhold information from our patients is a radical departure from the way health care has operated in this country until now and a clear violation of medical ethics,” Lubin-Johnson said. “Like other policies being advanced by this administration, this rule will have dire and disproportionate consequences for African-American patients.”
Dr. Judith Flores, chair of the Board of Directors, National Hispanic Medical Association, was similarly troubled by the potential impact the change would have on Hispanic patients, who account for roughly one third of Title X recipients. “As an organization, we are outraged by the Trump administration’s gag rule,” Flores said on the same phone call. “The rule violates medical ethics, severely limits access to medical services and will have negative impact on the health of the communities we serve. This ruling would undo the progress we have made at increasing the access to care in particular to Hispanics through the Affordable Care Act… [and] it will undermine relationships we have established, ideally, over several decades trying to engage populations that are on the margins of health care.”
Wen, for her part, pledged on Friday that Planned Parenthood would fight the rule, and the organization could have help in that fight from the ACLU. A representative for the organization said Friday it is reviewing the rule and considering the options it might have to challenge it in court.
In a separate statement, Ruth Harlow, senior staff attorney for the ACLU’s Reproductive Freedom Project, said, “Nobody should be denied access to reproductive health care or receive inadequate care because of their lack of income. We won’t sit back while Trump upends the family planning safety net as part of his anti-woman, anti-poor, and anti-health care agenda.”