The Trump administration’s 2019 final regulatory changes to the Title X national family planning program (commonly referred to as the Title X or domestic gag rule) aims to fundamentally subvert the core purpose of the program by reshaping the scope of services and network of entities supported by Title X funds.

The Guttmacher Institute filed a declaration in support of a case brought against the administration on behalf of the National Family Planning & Reproductive Health Association by the American Civil Liberties Union that opposes the new rule. The Institute’s declaration was also filed in support of cases brought by Planned Parenthood Federation of America and the American Medical Association; the California Attorney General; and Essential Access Health, the Title X grantee in California.

The declaration argues that, if implemented as written, the new rule would immediately harm people seeking care at Title X-supported sites, with negative ramifications for public health. The new rule would impose substandard care on those who turn to Title X-supported sites for care and disrupt the network of Title X-supported safety-net providers committed to delivering high-quality, patient-centered family planning services. 

Specifically, the new rule would deprive pregnant patients of nondirective counseling on all of their options; prohibit abortion referral while mandating referrals for prenatal care regardless of a patient’s wishes; compromise patients’ ability to choose from a broad range of contraceptive options and obtain the methods that will work best for them; and increase (rather than continue to help diminish) individuals’ risk of becoming pregnant when they do not want to do so.

Moreover, the new rule would force many of the high-quality, experienced providers that have long been trusted sources of Title X-supported care from the program by imposing unnecessary and stringent requirements on the separation of Title X–funded activities from not just abortion, but also a wide range of services that fall under the administration’s construct of prohibited abortion-related activities. Without similarly effective providers to take their place, these departures would result in a reduction in patients served and further hamstring Title X.

The full text of this article is only available in PDF.