Without court action, Planned Parenthood says its health centers will withdraw from Title X over 'gag rule'

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Without court action, Planned Parenthood said it will withdraw from the Title X program by the close of business Monday. (iStock/Michał Chodyra)

Planned Parenthood Wednesday notified the Ninth Circuit Court of Appeals that unless it steps in by Aug. 19 to block the Trump administration’s new Title X rule, its health centers will be forced out of the federal program in just days.

Planned Parenthood, which says it serves 40% of the country’s 4 million Title X patients, said it will withdraw from the family planning program next Monday—the deadline given by the Department of Health and Human Services (HHS) for all direct Title X grantees to submit a plan for complying with the new rule.

In a letter (PDF) to the court, an attorney representing Planned Parenthood said that without emergency relief, all Planned Parenthood clinics that receive Title X funding will be forced to withdraw from the program by the close of business Monday. The American Medical Association, which opposes the Title X final rule because it says it is a "gag order" on what physicians can say to patients about abortion services, is a party to the lawsuit.

Given that fast-approaching deadline, Planned Parenthood urged the court to act on its pending emergency motion for the full court or an en banc panel to reconsider a July 11 decision that allowed HHS to go ahead with changes to the family planning program.

RELATED: Appeals court lets Title X 'gag rule' go into effect, allows Trump family planning restrictions

In a 7-4 vote, the appeals court ruled that a June 20 ruling by a three-judge panel would be allowed to stand, lifting injunctions from lower courts that blocked enforcement of the rule, which makes clinics ineligible for Title X funds if they provide abortion referrals. However, the court said it would “proceed expeditiously to rehear and reconsider” arguments in the case.

The court is not scheduled to hear oral arguments until the week of Sept. 23. The new rules block federal funding for clinics offering abortion services.

Without court action before Monday, Planned Parenthood health centers will be forced out of the program, putting access to affordable birth control and other essential healthcare at risk, the organization said in a statement.

RELATED: AMA files lawsuit to block Title X rule restricting abortion clinic funding

“We refuse to let the Trump administration bully us into withholding abortion information from our patients. The gag rule is unethical and dangerous, and we will not subject our patients to it,” said Alexis McGill Johnson, acting president and CEO of Planned Parenthood.

“Every person deserves to make their own decisions about their healthcare—not to have Donald Trump or Mike Pence make those decisions for them. Let’s call this rule what it is—unethical, and a gag on healthcare providers,” she said.

The rule makes it illegal for any provider in the Title X program to tell patients how or where to access abortion and starting next year will impose “physical separation” restrictions on health centers that provide abortion.

Planned Parenthood said those are moves clearly meant to push its health centers and other reproductive healthcare providers out of the Title X program. HHS this year awarded $1.7 million in Title X funding to the Obria Group in California, an anti-abortion group that does not provide contraceptives, the group said.

“The Trump administration is targeting providers like Planned Parenthood in an attempt to end access to birth control and other reproductive healthcare,” McGill Johnson said.

HHS has told Title X grantees that they must provide “written assurance” and an “action plan describing the steps that they will take to come into compliance” with the Title X rule.

If it is not blocked by the courts, the Title X rule will “shatter the long-standing provider network” and leave patients without care, said Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association, which represents publicly funded family planning providers and administrators.

“The administration’s Title X rule is forcing the program’s 90 grantees and nearly 4,000 service sites to make gut-wrenching choices. They can stay in the program, despite the rule’s harms and compromises to Title X’s quality of care, for the sake of continuing to offer some Title X care for low-income individuals. Or they can leave the program and forego funding in order to avoid the rule’s limits on pregnancy counseling and other essential care, contrary to HHS’s own professional standards,” Coleman said, adding the group anticipates further withdrawals from the program.

Planned Parenthood is also hoping Congress will act to protect Title X funding. A spending package passed by the House of Representatives in June included language reversing the Trump administration rule. But action by the Republican-led Senate is unlikely.

Planned Parenthood said it is not the only direct grantee that will drop out of Title X, as providers that serve nearly half all Title X patients would leave the program.

So far, the governors of five states—Hawaii, Illinois, New York, Oregon and Washington—have said they would not participate in Title X if the gag rule is implemented. Massachusetts and Maryland have passed laws to that effect. Maine Family Planning, the only Title X grantee in that state, has announced it is leaving the program.