Trump administration to tie health facilities' funding to abortion restrictions

The policy would be a return to one instituted in 1988 by President Ronald Reagan that required abortion services to have a “physical separation” and “separate personnel” from other family planning activities. That policy is often described as a domestic gag rule because it barred caregivers at facilities that received family planning funds from providing any information to patients about an abortion or where to receive one.

Federal family planning laws already bar direct funding of organizations that use abortion as a family planning method. But conservative activists and Republican lawmakers have been pressing Alex M. Azar II, the secretary of health and human services, to tighten the rules further so that abortions could not occur — or be performed by the same staff — at locations that receive Title X federal family planning money.

Dawn Laguens, the executive vice president of Planned Parenthood Federation of America, called the new proposal “outrageous” and “dangerous.”

The policy, she said in a statement late Thursday, is “designed to make it impossible for millions of patients to get birth control or preventive care from reproductive health care providers like Planned Parenthood. This is designed to force doctors and nurses to lie to their patients. It would have devastating consequences across this country.”

Marjorie Dannenfelser, the president of the Susan B. Anthony List, a group that opposes abortion rights, thanked Trump on Thursday night in a statement in which she said the move would “energize” conservative voters heading into the midterm congressional elections this fall.

“We thank President Trump for taking action to disentangle taxpayers from the abortion business,” Dannenfelser said. She said that Trump “has shown decisive leadership, delivering on a key promise to pro-life voters who worked so hard to elect him.”

Two White House officials and two other people briefed on the plans said Thursday that the Trump administration will announce it is adopting the policy Friday, a move that they planned to outline for social conservative and religious activists during an early-morning telephone briefing. They all spoke on the condition of anonymity because they were not authorized to discuss the plans.

One Trump official said the rule would give Planned Parenthood and other groups that receive federal family planning money a choice: disentangle themselves from abortion or lose government funding.

The official said the policy would require “a bright line of physical as well as financial separation” between programs that receive Title X funding and those that perform, support or make referrals for abortions.

A Trump administration official who detailed the forthcoming proposal said it would neither prohibit nor require counseling on abortion.

The policy could prompt legal challenges as it did soon after the Reagan administration adopted it. Planned Parenthood and other groups filed lawsuits that blocked the rules, and while the Supreme Court decided in 1991 that they could move forward, they were never fully carried out. President Bill Clinton rescinded the policy in 1994.

Trump has shown ambivalence about Planned Parenthood, sometimes expressing support for its health-related services other than abortion. His daughter Ivanka Trump, a senior adviser, has urged him not to strip funding for the organization, as many Republicans have proposed, warning of the possible political repercussions.

Trump is set next week to give the keynote speech at the Campaign for Life gala held by the Susan B. Anthony List. Dannenfelser has called Trump “the most pro-life president in our nation’s history.”

The Trump administration has pressed repeatedly to impose abortion limits. Upon taking office, Trump signed a presidential memorandum reinstituting and expanding the global gag rule, which bars federal funding for organizations around the world that provide abortion counseling or referrals.

Trump has also taken particular aim at Planned Parenthood, which serves 41 percent of women who receive federally funded family planning services. He signed legislation last year aimed at cutting off government money from the group and others that perform abortions.

The bill nullified a rule completed in the last days of the Obama administration that effectively barred state and local governments from withholding federal funding for family planning services related to contraception, sexually transmitted infections, fertility, pregnancy care and breast and cervical cancer screening from qualified health providers — regardless of whether they also performed abortions.

Doctors have also expressed alarm at the prospect of such changes to federal family planning rules. In a conference call this month, officials from the American College of Physicians and the American College of Obstetricians and Gynecologists said the policy would harm women’s health.

Dr. Hal Lawrence, the executive vice president and chief executive of American College of Obstetricians and Gynecologists, said during that call: “We don’t need the government interfering in the exam room, and the government should not be interfering in what women can know and what kind of options she should be given.”

Abortion rights advocates also argue that the new rules could result in women not receiving reproductive health care at all, leading to more unintended pregnancies and higher mortality rates. They note that Planned Parenthood and other groups that perform abortions are often the only federally funded health care providers in certain areas of the country, meaning that some women in those places may simply not receive medical care at all under the new policy.

Cecile Richards, the former president of Planned Parenthood, wrote in her memoir published last month that during a meeting in January 2017 with Ivanka Trump and her husband, Jared Kushner, who is also a senior adviser to the president, the couple offered her a deal for her organization: stop providing abortions in exchange for receiving an increase in federal money. Donald Trump acknowledged a few weeks later that he had pushed for such a deal.

At the time, Planned Parenthood publicly rejected the proposal out of hand, saying it would never agree to a scheme that would compel it to stop offering or advising women about abortions.

This article originally appeared in The New York Times.

Trump administration to tie health facilities' funding to abortion restrictions

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