Trump’s changes to the program, which went into effect in 2019, banned family planning dollars for abortion providers and those who referred patients for the procedure. Democrats and abortion rights groups said the policy was a “gag rule” while anti-abortion groups, consistent with the previous government, said federal funding should never go to abortion providers, although long-standing rules already prohibit federal funding for abortion, except In rare cases.
The Trump policy also called for clinics to provide abortions as well as Title X services like STD testing and birth control to create two physically separate facilities.
In the rule released on Wednesday, the Biden administration said roughly a quarter of program providers have left due to the restrictions, and the program has 1,000 fewer service points and 22 percent fewer patients across the country. Six states have lost all of their Title X providers, while another six have lost the vast majority, according to the health department, which estimated the changes resulted in 181,477 unwanted pregnancies.
“The impact of the 2019 final rule was devastating to hundreds of thousands of Titel X customers who have lost access to critical family planning and related preventive health services,” the new rule reads.
But despite progressive groups calling for the Biden administration to suspend enforcement of Trump-era policies while its revision goes through the regulatory process, those restrictions will remain in place until Biden’s rule is finalized later this year. A spokesman for HHS said federal law mandating the rule-making process prevented the department from overturning Trump policy sooner because Biden wanted to make sure the revision survived potential litigation.
Still, reproductive rights groups, including those who challenged Trump’s policies in court, expressed frustration with the decision.
“Every day the old regulations stay in place, the federal government is mandating lower standards of care for low-income patients,” said Julie Rabinovitz, president and CEO of Essential Access Health, the California lead-X grantee.
Rabinovitz said that in the two years since the Trump rules went into effect, their network of Title X clinics has shrunk from 366 in 38 counties to 238 in 20 counties. Most vendors who have left the company have signaled that they are ready to rejoin once the Trump-era restrictions are lifted, she said.
Planned Parenthood, who lost about $ 60 million in federal funding on exiting Title X and previously cared for more than 40 percent of the program’s patients, won’t be able to return to the program until later this year.
Anti-abortion groups celebrating Trump’s Title X rules have not signaled whether they will challenge the rollback in court. But they are calling on the Supreme Court to hear a pending lawsuit over Trump’s policies in the hopes that the Conservative 6-3 majority would support them. This would make it easier for a future Republican government to reintroduce the restrictions. Groups like Susan B. Anthony List have also pledged to launch a campaign to flip the house in 2022 highlighting what they refer to as “abortion extremism” by the Democrats.
The National Association for Family Planning and Reproductive Health, which includes providers who left Title X in protest of the Trump rules, and sites that chose to stay and comply, complained that the latest budget the Biden administration should have asked for more money for Title X for the Trump cuts.
“President Biden has had several options to expedite restoration of this network, but at every turn his government is not responding to desperate and urgent calls for help,” said Clare Coleman, group president and CEO, has a stated commitment to assist family planning providers with this budget proposal , undercut, has chosen to keep the field in a dangerous waiting pattern with a lengthy regulatory process. “
The HHS spokesman countered that the administration’s $ 340 million proposal represents an 18.7 percent increase over the program’s current funding levels and more money than Title X has ever received in its 50+ year history Has.
Biden’s $ 1.9 trillion Covid bailout package passed in March also included an additional $ 50 million markup for current Title X providers to help weather the pandemic – a move anti-abortion groups despite The Trump restrictions on abortion providers, labeled a “bailout for the abortion industry,” remain in effect for the time being.
The spokesman said the funding request was consistent with the values of the administration and that the proposed update included a broader definition of “family planning” and an increased focus on racial justice.
In his previous role as California attorney general, HHS Secretary Xavier Becerra led a coalition of blue states to sue the Trump administration over the Title X rule. The lower federal courts have joined these states, but the appeals courts have allowed them to take effect anywhere except Maryland. The Supreme Court announced earlier this year that it would hear the case, but the Biden administration has asked the judges to dismiss it.
HHS said that due to its prior involvement, Becerra will be excluded from any litigation over Title X but will be involved in drafting the new rule.