Trump Administration Assault on Women’s Health and Reproductive Rights
By Jill Zorn |
The Trump administration has proposed a new rule for the Title X program, posing a major threat to women’s health care and reproductive rights.
Title X funds reproductive health services for low income people. It also funds preventive health care such as well-woman exams, cancer screenings, screening and treatment for sexually transmitted infections, testing for HIV and patient education. These services save lives.
Over 43,000 people in Connecticut were served by the Title X program last year, 87% of them by Planned Parenthood. While the program mainly served women, 14% of patients were men.
Universal Health Care Foundation of Connecticut submitted public comment urging rejection of the proposed rule. The public comment period closed July 31 and the final regulations could be published as soon as the early fall.
Our comments focused on three issues:
Government Interference in the Practice of Medicine
The proposed rule would prohibit doctors, nurses and other health care providers from counseling pregnant patients about the full range of medically appropriate options available to them, including pregnancy termination, or from referring patients for abortion services, even when requested. Denying or delaying Title X patients’ ability to obtain abortions jeopardizes their health and well-being. And this “gag rule” goes completely against the ethical standards of health care professionals, jeopardizing an open, trusting relationship with their patients.
Furthermore, the proposed rule would no longer require Title X providers to offer all FDA-approved contraceptive methods to their patients. In fact, the proposed definition of “family planning” appears to favor much less effective methods such as abstinence.
This approach undermines a law passed with bipartisan support in the Connecticut General Assembly in the 2018 session, HB 5210, An Act Mandating the Coverage of Essential Health Benefits. This new state law specifically requires insurance coverage of all FDA-approved contraceptive methods and requires these preventive services be offered without cost-sharing.
Impact on Planned Parenthood
The proposed rule appears to directly target Planned Parenthood, by requiring complete physical and financial separation of abortion services from other services the agency provides. Planned Parenthood of Southern New England is a crucial provider of affordable reproductive health care services in our state. In 2017 the organization cared for the large majority of Title X patients: 37,973 out of a total of 43,835 (87%). Eliminating Planned Parenthood from the Title X program would leave many people without access to care, as other health care providers do not have the capacity to handle the additional patient load.
Health Disparities
The proposed rule would have a particularly negative impact on people of color and people with low incomes, widening the health disparities that exist in Connecticut. In 2017 28% of the patients served by Title X were Hispanic or Latino and 23% were Black or African American. The large majority (85%) of patients served had incomes under 200% of the federal poverty level. Access to care should not be based on ability to pay. If the rule goes through, the harmful impacts will fall most heavily on the people who are most in need of comprehensive, affordable, reproductive and preventive health care services.
The proposed changes to Title X represent yet another Trump administration assault on health and health care. If enacted, the new regulations could keep tens of thousands of people in Connecticut and millions across the country from accessing the comprehensive services and unbiased information they need to protect their health and make informed decisions about their care. The Foundation will continue to speak out against these attacks as we advocate for universal access to quality, affordable health care in Connecticut.
More information on the proposed rule
- A Domestic Gag Rule And More: The Trump Administration’s Proposed Changes To Title X, Health Affairs Blog
- Proposed Changes to Title X: Implications for Women and Family Planning Providers, Kaiser Family Foundation Issue Brief
Other resources
- Comment letter submitted by several state Attorneys General, including Connecticut’s George Jepsen, seeking withdrawal of the proposed rule
- Letter sent in opposition to the rule by Connecticut’s Congressional delegation
- Joint statement by eight women and children’s health provider organizations opposing, “…all efforts to exclude qualified women’s health service providers and limit health care information through the Title X program.”
- Opinion piece in the Baltimore Sun, “Trump’s Family Planning Dystopia”, by Baltimore’s Health Commissioner, Dr. Leana Wen