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What the White House’s proposed rule to block abortion funds means for women’s health

The Trump administration proposed a new rule Friday that would take federal funding away from health clinics that perform abortions or provide referrals to other clinics with abortion services.

The rule, White House officials said Friday, would prohibit doctors, nurses, hospitals, community health centers and clinics that receive federal Title X funds, which cover family planning services, from providing abortions or referring women to clinics that provide abortions, even if they ask.

The rule, which was submitted by the Department of Health and Human Services to the Office of Management and Budget for review Friday, would be the latest move by President Donald Trump, who campaigned as a pro-life candidate, to restrict access to abortion. The White House and Department of Health and Human Services put out statements Friday calling the expected rule an example of “another promise made and kept.”

Opponents criticized the change, saying it would negatively impact millions of women and impose a so-called gag rule on providing patients with information on abortion, and that it represented an attack on Planned Parenthood.

The rule is “a far-reaching attack and attempt to take away women’s basic rights and reproductive rights, period,” Dawn Laguens, Planned Parenthood’s executive vice president, said on a call with reporters Friday.

Women’s health groups have braced for federal changes to Title X programs, which provide 4 million patients nationwide with contraception and family planning. Planned Parenthood is the largest service provider in that group; the organization said Friday that it receives more than $50 million in Title X funding per year and treats 41 percent of patients who receive Title X services.

Currently, no federal funds pay for abortions, and Planned Parenthood uses private dollars to pay for the abortions it does offer.

Planned Parenthood has been targeted for years by conservatives for its role in facilitating abortions, and is often at the center of the political debate on the issue. Roughly half of all Planned Parenthood health centers offer abortions, something Republicans in Congress frequently cite in efforts to cut the groups’ federal funding.

What could this proposed rule do?

The rule had not been made public as of Friday afternoon, so some of its details remain unclear. But officials from the White House and the Department of Health and Human Services told reporters that the rule would require a physical and financial separation of facilities and services that receive federal Title X funds from those that offer abortion.

“This proposal does not necessarily defund Planned Parenthood, as long as they’re willing to disentangle taxpayer funds from abortion as a method of family planning, which is required by the Title X law,” the White House said in a statement.

Critics argued that the change would force clinics that receive Title X funds to open a separate building to offer abortions — while at the same time not allowing staff to refer patients to that building for abortions. Opponents of the rule, including Planned Parenthood, also said it would remove the guarantee that patients “are getting full and accurate information from their doctors,” Laguens said.

In opposing the rule, Laguens, Planned Parenthood’s executive vice president, also criticized Trump’s grasp of health care policy.

“A president who doesn’t know the difference between HIV and HPV shouldn’t be interfering with doctor-patient relationship,” Laguens said. She was referring to a leaked speech by Microsoft founder Bill Gates this week in which he said that Trump asked him twice in separate meetings to explain the difference between HIV and HPV.

What’s the historical precedent?

As candidates, Trump and Vice-President Mike Pence vowed to pursue anti-abortion policies. But the rule announced Friday is part of a decades-long push by Republicans to limit access to abortions. On Friday, critics immediately compared the new rule to the abortion policies President Ronald Reagan pursued in the 1980s. During a 1988 March for Life rally, Reagan vowed to implement new regulations that “will put an end to this conflict of interest in cases where Title X funds are involved.”

Reagan pushed for policies that prohibited Title X money to pay for any programs that perform abortions, requiring family planning programs “to be both financially and physically separate from facilities that use abortion as a method of family planning,” he said.

In 1991, the Supreme Court issued a 5-4 decision in Rust v. Sullivan that said the federal government cannot fund abortion counseling when covering family planning services.

Who would be most affected by this change?

Women’s health advocates said that people who qualify for low-income services could be most at-risk if they lose access to Planned Parenthood. In addition to family planning, contraception, reproductive care, and in some cases abortions, affiliated clinics also offer cancer screenings and treatment for sexually transmitted diseases.

What’s next?

The new rule is an administrative rule, which means it doesn’t require congressional action or approval. After the rule was submitted, it entered the agency rule-making process. Here’s how that breaks down:

Once the Office of Management and Budget formally accepts the submitted rule from the Department of Health and Human Services, the clock starts on a public comment period of 30 to 60 days.
After the public comment period closes, those public comments would be reviewed and then a rule would most likely be issued.

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