by Craig Klugman, Ph.D.
The Trump Administration is moving forward on a new Title X rule first proposed in June 2018 that would prohibit any federal funds from going to organizations that perform or refer women to facilities that offer abortion. This move is an extension of the “global gag rule” that forbids US funds from going to organizations that perform, refer, counsel, or even mention the word abortion.
The 40-year-old Title X program provides family planning and preventive health services for low income women. Approximately 4 million women get their care through this $286 million program. The main provider is Planned Parenthood which sees 41 percent of all Title X patients and uses the funds for wellness exams, cancer screenings, birth control, family planning education, and STI testing and treatment. By existing federal law (the Hyde Amendment), federal money cannot be used to pay for abortions. What is new in the Title X rules is that to keep their Title X funding, any group that performs abortions will have to move that medical procedure to a separate physical facility and will not be permitted to refer patients to an abortion provide (including themselves). For many women, Planned Parenthood is the only provider of these services in their region and thus it will mostly hit women who identify as minority, lower socioeconomic, and rural.
The move is an attempt for the Trump Administration to appeal to conservative voters. Some critics like Michelle Goldberg of the New York Times calls the move “pork for the religious right” and an attempt to control women’s bodies and lives. Goldberg views this rule as a move toward creating Gilead, the fictional religiously-based United States of The Handmaid’s Tale.
Under the rules, doctors are not permitted to bring up the option of abortion or to offer information about any abortion providers. This is an effort to decrease the number of abortions, a trend that has occurred without any government intervention. Besides interfering with the patient-provider relationship and legislating medical speech, the effort restricts procreative liberty and may even violate the establishment of a state religion.
For supporters, the move helps fulfill a long-time dream of making abortion illegal and an effort to reverse Roe v. Wade. For many this belief stems from their notions that abortion violates their religious beliefs. Consider that according to the Pew Research Forum, 33% of people they have surveyed believe that religion is the source of right and wrong. Others find different sources
- 11% in philosophy and reason
- 45% in common sense
- 9% in science and
- 3% do not know.
The Pew Forum identified characteristics of people who believe that religion is the source of right and wrong: They tend to be Christian, over 30 years of age, identify as a Baby Boomer or older, have lower levels of formal education, view religion as very important in their lives, and have absolute certainty in the existence of God. Philosophically, this group also holds that right and wrong are absolute standards with no exceptions irrespective of the situation. They tend to view religious scripture as the direct word of God. As a result of their resolute beliefs, 71% of people who place right and wrong as the determination of religion believe that abortion should be illegal.
It is not a coincidence that the Administration is choosing a rule that aligns with the belief systems of its most ardent supporters even though this move threatens to undermine patient and physician autonomy. The fact that this move will remove care from millions of women seems not to matter in the pursuit of political points. The concern is not about helping women but instead about scoring points with its shrinking base.
The new rules would not come into effect until 60 days after they appear in the Federal Register and they will most certainly be subject to a lawsuit. Already, Washington State has announced its plan to sue the Administration over these new Title X restrictions. Perhaps this is the ultimate goal since such a lawsuit would most likely make its way to a now more conservative Supreme Court, one that is being seen as a possible end to Roe v. Wade and a women’s right to choose.