Sun Sentinel Palm Beach Edition
Court upholds abortion policy
A Trump administration rule bans taxpayer-funded clinics from referring women for abortions.
SEATTLE — In a victory for the Trump administration, a U.S. appeals court on Monday upheld rules that bar taxpayer-funded family-planning clinics from referring women for abortions.
The 7-4 ruling by the 9th U.S. Circuit Court of Appeals overturned decisions issued by judges in Washington, Oregon and California. The court had already allowed the administration’s changes to start taking effect while the government appealed those rulings.
The changes ban taxpayer-funded clinics in the Title X program for lowincome women from making abortion referrals, a restriction opponents characterize as a “gag rule.”
Beginning March 4, the rules will also prohibit clinics that receive federal money from sharing office space with abortion providers, which critics said would force many Title X providers to find new locations, undergo expensive remodels or shut down — further reducing access to the program.
Title X patients receive affordable birth control, reproductive care and other care through the program, including breast and cervical cancer screenings and HIV testing.
Abortion is a legal medical procedure, but federal laws prohibit the use of Title X or other taxpayer funds to pay for abortions except in cases of rape, incest, or to save the life of the woman. Under Title X, a 1970 law designed to improve access to family planning services, federal money may not be used in programs “where abortion is a method of family planning.”
Abortion rights supporters and opponents have argued for decades whether counseling a patient about abortion or referring a patient to a different provider for an abortion violates that language. Abortion opponents and religious conservatives say Title X has long been used to indirectly subsidize abortion providers.
“Congress has long prohibited the use of Title X funds in programs where abortion is a method of family planning and (the Department of Health and Human Service’s) recent rule makes that long-standing prohibition a reality,” U.S. Justice Department spokeswoman Mollie Timmons said in a written statement celebrating the 9th Circuit’s ruling. “We look forward to continuing to defend this vital rule against all challenges.”
More than 20 states and several civil rights and health organizations challenged the rules in cases filed in Oregon, Washington and California. Judges in all three states blocked them from taking effect, with Oregon and Washington courts issuing nationwide injunctions.
One judge called the new policy “madness” and said it was motivated by “an arrogant assumption that the government is better suited to direct women’s health care than their providers.”
Planned Parenthood, which served 1.6 million of the 4 million patients who received care through Title X, has already left the program in protest, giving up about $60 million a year in federal funding.
Overall, nearly 1,000 clinics have left Title X, according to the National Family Planning and Reproductive Health Association. Washington and Oregon have abandoned the program entirely. In Vermont, all of the Title X clinics were Planned Parenthood, leaving none there.
In California, the number of patients served by the program has fallen 40% under Trump’s rules — and it will fall further once the physical separation requirement takes effect March 4, said Essential Access Health, which administers Title X in California.
The American Medical Association criticized the ruling as “government overreach and interference” that prohibits frank conversations between physicians and their patients.
“It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options,” the AMA said in a statement.