Editor's note: The original article was edited to include additional reaction.
As the battle over a new Title X final rule continues to play out in court, the Trump administration says it will begin enforcing those new family planning funding restrictions.
An en banc panel of the 9th Circuit Court of Appeals last week rejected emergency petitions filed by opponents to block the Trump administration from implementing the new rule and the Department of Health and Human Services (HHS) said Monday it will immediately begin enforcing the abortion restrictions, according to news reports.
The new rule is opposed by many physician groups including the American Medical Association, which joined Planned Parenthood in legal action to block the restrictions that it has called a “gag rule” on what physicians and other clinicians can say to patients.
The Trump administration said family planning clinics that accept Title X funding must stop referring women for abortions immediately as it begins enforcing the new rule, according to the Associated Press.
The announcement was made ahead of a planned conference by HHS’ Office of Population Affairs with Title X grantees that begins today. HHS formally notified the clinics that it will begin enforcing the ban on abortion referrals, along with the requirement that clinics maintain separate finances from facilities that provide abortions, the AP reported.
A requirement that abortion services and Title X services be performed in separate facilities will not take effect until next year.
The new regulation is supported by pro-life groups and religious conservatives but opposed by many medical organizations and women’s rights groups.
The final rule is largely seen as a direct attack on Planned Parenthood, the largest reproductive health and abortion provider in the U.S. The final rule requires providers that receive Title X funding to maintain "physical and financial separation" from an abortion provider.
The National Family Planning & Reproductive Health Association (NFPRHA), an umbrella group that represents family planning clinics, said last week’s court ruling means that the preliminary injunctions barring implementation of the Title X final rule are not currently in effect. “NFPRHA continues to believe that Title X-funded settings should await written guidance from the Office of Population Affairs (OPA) or the US Department of Health and Human Services (HHS) before implementing the rule, though entities should seek the advice of local counsel to assess their risks and next steps,” the group said in a statement on its web site.
In a statement issued today, NFPRHA said it was concerned that the Office of Population Affairs released the notice to Title X grantees that it will begin enforcing the final rule, without providing any detailed guidance around compliance. “The announcement from HHS that the Title X rule is in immediate effect comes without any guidance for providers about what steps are necessary to comply with the requirements in this sweeping new regulation,” said Clare Coleman, president and CEO.
“This rule will shatter the long-standing provider network—leaving hundreds of thousands of vulnerable patients without essential care. Last night’s notice will prompt grantees and other participating entities to withdraw from Title X, and we anticipate withdrawals beginning this week,” she said.
HHS notified Title X grantees it will begin enforcing the Title X rule immediately, without providing any detailed guidance about how providers must comply with the new restrictions. Read NFPRHA’s full response. https://t.co/Hy2xwUfor0 pic.twitter.com/EJZP6ZZoFC— NFPRHA (@NFPRHA) July 16, 2019
In response to HHS’ decision to enforce the rule, Michelle Kuppersmith, director of Equity Forward, a watchdog organization, said it will hurt patients.
“For more than two years, the Trump administration’s needless meddling and mismanagement of Title X has led to uncertainty and confusion. Moving forward with this policy to take away women’s rights before the legal process has played out is reckless and will hurt those whom HHS is supposed to serve,” she said in a statement.
The pro-life group Americans United for Life welcomed the news that HHS will enforce the final rule that will prevent physicians from referring patients for abortion in a Title X program. “Planned Parenthood and others want to use public Title X funds to support their abortion services in blatant disregard of Congress explicitly and statutorily excluded abortion from the scope of Title X projects and funding. In reality, no physician in America is being stopped from referring a patient for an abortion—they just can't demand taxpayer funding to do so,” said its president and CEO Catherine Glenn Foster.
In the meantime, the court battle goes on. On June 20, a three-judge panel of the Ninth Circuit granted HHS’ request to stay injunctions blocking implementation of the Title X final rule. Opponents, including NFPHRA, filed emergency motions to the en banc panel seeking a re-hearing and asked the court to reinstate the preliminary injunction that blocked implementation pending appeal.
On July 11, the en banc panel of judges denied the request to restore the preliminary injunction while the rehearing process moves forward.
Physician groups have said the rule will prevent doctors from talking to patients about all their options, including referring women for abortions under the family planning program.