Title X Rule One Year Later

 Almost one year ago, the Trump Administration announced proposed changes to the Title X (read Title Ten) family planning program that would fundamentally alter the way the program operates. The proposed rule would block healthcare providers from receiving Title X dollars if they provide, or even mention, abortion care to their patients. Title X, established in 1970, provides reproductive care to people with low incomes, including those who couldn't afford healthcare on their own. Title X funds do not — and cannot — pay for abortion services due to the 1976 Hyde Amendment, which bans federal dollars from paying for abortion care.

In its final writing, the new Title X rule — also known as the domestic "gag" rule — would silence, or put a gag, on healthcare providers in the Title X program, making it illegal for them to talk with patients about accessing safe, legal abortion. This prevents patients from getting full and accurate information about all of their health care options. Because Planned Parenthood is dedicated to comprehensive, ethical care that offers complete information to patients, their health centers would no longer be able to take part in the Title X program. This means that individuals covered under the Title X program may face difficulty in accessing care in the future. Planned Parenthood serves 41 percent of Title X patients in the country— about 1.6 million people. Often, Planned Parenthood is the only source for reproductive care, meaning that Title X patients would have nowhere to turn when this rule goes into effect. The gag rule also disproportionately harms people of color, LGBTQ communities, and those in rural areas, since these groups already face difficulty accessing healthcare due to factors including racism, homophobia, transphobia, and economic barriers.

This rule is not only dangerous, but it is also unpopular. The Title X rule is opposed by 73 percent of the American public, more than 200 members of Congress, 15 governors, and more than 100 public health institutions, just to name a few. Supporters of the rule include Donald Trump, Mike Pence, Secretary of Health and Human Services Alex Azar, and other appointed officials in the Trump Administration. It is worth emphasizing that one politician also in favor of this rule is Erie's Congressman Mike Kelly. Last July, he signed on to a letter to Secretary Azar voicing his support for this rule.

Luckily, the gag rule has been stopped from going into effect for now. In recent weeks, federal judges issued injunctions that would allow providers like Planned Parenthood to continue receiving Title X funds to serve their patients. In addition, the U.S. House of Representatives' Labor, Health and Human Services, and Education Appropriations subcommittee included language in the government's annual budget bill to protect Title X. The bill language makes clear that Congress is in charge of the Title X program and will not fund the Trump-Pence administration's gag rule. Instead, Congress will only allow this funding to be used to carry out the program as it has been historically run.

We know what happens when governments defund family planning services because we've seen it happen at the state level. In Texas, after Planned Parenthood was eliminated from the state program, pregnancy-related deaths doubled. Funding cuts in Indiana led to closure of a Planned Parenthood health center in rural Scott County; the clinic was the only provider of HIV testing in the region. Following the closure, Scott County experienced an unprecedented HIV outbreak. When the Planned Parenthood health center closed in Shawano County, Wisconsin after state cuts, chlamydia and gonorrhea infections increased, and former patients faced significant waiting lists to see a doctor at a community health clinic.

Planned Parenthood's doors will stay open, and we will survive as we have survived previous attempts to strip away reproductive care from millions of Americans. These attacks have built a movement where voters are demanding elected officials stop pursuing dangerous and unpopular legislation that hurts women. In cases where our representatives refuse to listen, we've shown that they'll be challenged. In Erie, we saw a formidable challenger (Ron DiNicola) take on Congressman Kelly, and without the benefit of a district gerrymandered in his favor, the race was actually competitive. Though Representative Kelly ultimately won the seat, he returns to Washington in the minority facing the first ever pro-reproductive rights majority in the House. This change in our House of Representatives, and all of the wins we are seeing across the country, are just the beginning. We are resilient, organized, and ready. In fact, Mike Kelly was one of 43 representatives put "on notice" for 2020 by Emily's List, a group dedicated to electing pro-choice, Democratic women. We know that reclaiming our rights means reclaiming our government, and 2018 was just the beginning.

Paige Bosnyak is the Field Organizer for Planned Parenthood PA Advocates in Erie. To join Paige in the fight for reproductive rights, reach her at paige.bosnyak@pppamail.org.