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Trump-appointed judge rules family planning program can prioritize abstinence over contraception

Health groups say the move undermines a bipartisan public health program that has provided critical family planning services for decades.

Deanna Wambach, lead clinician at Planned Parenthood talks in one of the clinic rooms at Planned Parenthood Central Phoenix Health Center in Phoenix, Arizona on February 2, 2017.  / AFP / Laura Segall / TO GO WITH AFP STORY BY VERONIQUE  DUPONT-"Anxiety in family planning centers in the face of the Trump offensive"        (Photo credit should read LAURA SEGALL/AFP/Getty Images)
Deanna Wambach, lead clinician at Planned Parenthood talks in one of the clinic rooms at Planned Parenthood Central Phoenix Health Center in Phoenix, Arizona on February 2, 2017. / AFP / Laura Segall / TO GO WITH AFP STORY BY VERONIQUE DUPONT-"Anxiety in family planning centers in the face of the Trump offensive" (Photo credit should read LAURA SEGALL/AFP/Getty Images)

A federal judge decided against reproductive rights groups that sought to block the Trump administration’s latest efforts to undermine the federal Title X family planning program, ruling in favor of prioritizing abstinence and natural family planning methods over contraception.

In May, three Planned Parenthood affiliates and the National Family Planning & Reproductive Health Association (NFPRHA) filed a lawsuit in a federal district court, challenging proposed changes to the country’s only program dedicated to family planning, known as Title X.

The proposed changes affect the quality of care for low-income people who depend on public funds for their family planning care. People of color make up half of Title X clients; roughly 21 percent identify as black or African American and 30 percent identify as Hispanic or Latinx.

The Department of Health and Human Services (HHS) — packed with anti-abortion sympathizers — released a funding announcement in February, where they told interested parties they’ll be giving Title X dollars to groups who cooperate with faith-based organizations and have a “meaningful emphasis” on “stable, healthy marriages” and avoid “sexual risk.” The 60-page announcement made no mention of contraception, but instead, emphasized infertility services. By contrast, the Obama-era announcement promoted comprehensive contraceptive services, pregnancy testing, and counseling, in addition to basic infertility services.

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The changes prompted current family-planning grantees to sue HHS, saying officials violated the Administrative Procedure Act and Title X law because revisions were made in an “arbitrary and capricious” manner without public notice and rule making.

But Federal Judge Trevor McFadden — who was appointed by President Donald Trump in 2017 — ruled in favor of HHS, saying that “courts cannot… require formal rule-making for a change in agency procedure.”

It is unclear whether health groups will appeal the decision.

Credit: Guttmacher Institute
Credit: Guttmacher Institute

The grants total roughly $260 million, and Planned Parenthood receives $50 million to $60 million in annual funding. These dollars pay for the contraceptive care of 1.6 million of Planned Parenthood’s 3.8 million clients who need it.

The next Title X funding cycle starts in September and, given the new administration’s priorities, it’s possible this new program will open the door to abstinence-only providers and crisis pregnancy centers (CPCs) and shut out providers like Planned Parenthood.

ThinkProgress reached out to HHS for comment, but they did not immediately respond.

“This administration is attempting to undermine a public health program that was created with bipartisan support and that for decades has provided critical family planning services available to millions of people who could not otherwise afford it,” said Clare Coleman, president and CEO of NFPRHA. “We will continue to fight against attacks on family planning to ensure highly qualified health care providers can remain in the program and continue to deliver patient-centered contraceptive care for all who seek it.”

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“Planned Parenthood will not stop fighting for our patients and the four million people who depend on this health care,” said Dawn Laguens, executive vice president of Planned Parenthood Federation of America, in a statement. “This program is meant to ensure that every person — regardless of where they live, how much money they make, their background, or whether or not they have health insurance — has access to basic, preventive reproductive health care, such as birth control, cancer screenings, STI testing and treatment, and regular check-ups.”

Credit: Kaiser Family Foundation
Credit: Kaiser Family Foundation

This isn’t the Trump administration’s final footprint on the Title X program. Officials recently issued a new proposed rule that shores up the funding announcement, blocking federal funds to clinics that provide abortion services, like Planned Parenthood, and prevent groups from providing comprehensive counseling and referrals to abortion services. Title X dollars are already not permitted to pay for abortion services.

“These actions could shrink the network of providers that offer low-income women comprehensive family planning services using federal support,” according to a Kaiser Family Foundation brief on proposed changes to Title X. “In addition to the abortion-specific provisions, there are other notable changes in the proposed regulations that are administratively burdensome, weaken the clinical standards of family planning care offered by Title X providers, and redefine programmatic eligibility standards to promote Administration priorities.”

This proposed rule hasn’t been challenged by reproductive advocacy groups yet.