Administration targets family planning programs
On May 22, the Trump Administration announced rules reviving a Reaganera policy known as the Domestic Gag Rule that is designed to reduce access to abortion and contraception. The rule, which governs a key social safety net program (Title X), limits how clinicians can discuss abortion with their patients, excludes all providers who offer abortion services, introduces administrative burdens, and constrains teens’ access to contraception. The policy is not about stopping the use of federal funds for abortion. For over 40 years, it has been federal policy that federal funds cannot be used for abortion care. In Colorado, our state constitution bars state money from funding abortion care.
The Domestic Gag Rule will have reverberating consequences for women, especially those with limited economic resources, teenagers, and women of color. The rule has been firmly denounced by the American College of Obstetricians and Gynecologists and the national organization of Title X providers.
Currently, the federal family planning program (called Title X) supports 4,000 clinics nationwide, providing sexual and reproductive health services for roughly 4 million women, and preventing approximately 1.9 million unintended pregnancies every year. Colorado’s Title X program, administered by the Colorado Department of Public Health and Environment, has been studied by health care experts and providers nationwide because of its high-quality care and excellent outcomes. Now, the Trump administration is telling CDPHE who it can and cannot choose to deliver its programs.
The Title X program, started in 1970 by Congress and signed into law by President Richard Nixon, was designed to assure that all women, regardless of income, have access to highquality and freely-chosen reproductive health services. Until recently, the Title X program had been uncontroversial, supported by Democrats and Republicans alike.
The gag rule is part of a broader effort sometimes referred to as “defunding Planned Parenthood,” It started in Texas, and when we studied its impacts there, we found that when Planned Parenthood was excluded from a Texas family planning funding program, one-third fewer women got the most effective methods of contraception, and there was a 27 percent increase in Medicaid-funded births among women who used birth control methods that required regular visits to a health care provider.
Even though the cuts in Texas targeted Planned Parenthood, other smaller providers in non-urban areas bore the biggest impacts. And at least 82 family planning clinics closed. Here in Colorado, things will surely be similar. The more than 70 Title X clinics in Colorado provide cancer screenings, contraception and other basic health care, whether or not they provide abortion care and counseling using non-government funds. Some may be forced to close or reduce services.
In trying to anticipate the impacts of the Domestic Gag Rule, we can also turn to the Global Gag Rule, which restricts U.S. foreign aid to nongovernmental organizations that perform or provide information about abortion. Studies have shown that the Global Gag Rule increases abortion in the countries that rely most on U.S. aid. Just like in Texas, the Global Gag Rule targets the providers of abortion information or services but it ends up hurting women.
CDPHE has demonstrated what happens when government makes it easier to provide family planning services. After a program began in 2009 ensuring that Title X family planning providers throughout Colorado could offer the full range of contraceptives to all women, Colorado saw a 50 percent reduction in the teen fertility rate and a 50 percent reduction in the teen abortion rate. Colorado is now on the leading edge of providing highquality family planning for our citizens. The Domestic Gag Rule would jeopardize our excellent programs by dictating what Colorado health officials and health care providers can and cannot do.