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Planned Parenthood, American Medical Association, 22 states, D.C., sue HHS over Title X final rule

Gag order prevents Title X providers from telling pregnant patients how and where they can access abortion safely and legally, lawsuit says.

Susan Morse, Senior Editor

The Planned Parenthood Federation of America, the American Medical Association, Oregon Governor Kate Brown and others have filed a lawsuit in U.S. District Court in Oregon against the Department of Health and Human Services, claiming the final rule over Title X funding is unconstitutional.

They want the rule blocked. It's scheduled to take effect within 60 days.

The District of Columbia and 21 states also filed lawsuits on Monday and Tuesday against HHS. A California lawsuit was filed on Monday and the second lawsuit was filed Tuesday in U.S. District Court in Oregon by the Oregon governor and attorneys general in Oregon, New York and other states.

The Title X grant program funds family planning services. The money has always been barred from going directly towards abortions. Planned Parenthood affiliates provide abortion services outside of the Title X program.

The final rule takes a stronger stance, banning abortion referrals while mandating prenatal referrals.

Requirements over what patients and providers can talk about is at the core of the lawsuits. Rule opponents call it a gag order.

Also abortion services would be required to be separated from other services. This includes separate facilities, personnel, workstations and healthcare records.

In a change made after the rule was proposed in June and before the final rule was released this week, there is a speaker-based restriction on who can provide pregnancy counseling. Only physicians or advanced practice providers can provide such counseling, excluding nurses and healthcare assistants who also have traditionally taken on that role.

In all instances, the rule would compel practitioners to tell pregnant patients about the "risks and side effects to her unborn child," the lawsuit said.

WHY THIS MATTERS

HHS's final rule "would radically alter and decimate the family-planning assistance program established by Title X of the Public Health Service Act, with severe and irreparable public health consequences across the United States," the lawsuit by the AMA, Planned Parenthood and others said.

The final rule also politicizes the practice of medicine and the delivery of healthcare, it said.

"First, the final rule imposes a gag on the medical profession that would have practitioners in the Title X program direct pregnant women toward continuing a pregnancy to term - regardless of what a patient actually wants," the lawsuit  said. "In other words, Title X providers must not tell pregnant patients how and where they can access abortion safely and legally …"

The rule also imposes vague requirements to punish Title X providers for talking about or providing abortions with non-Title X funds, and coerce them into abandoning that constitutionally protected activity, the lawsuit said.

Money to comply with the rule would have to be siphoned from other services, threatening staff, hours and even closures, it said.

Americans United for Life said the terms of the new rule make it more clear that Americans don't want their tax dollars used to subsidize Planned Parenthood and other abortion services. Further, the new rule expands the scope of medical providers eligible to deliver Title X services, and adds critical new protections for victims of child trafficking and sexual exploitation, the organization said.

THE TREND

Among other services, Title X funds contraceptive services, education about natural family planning methods, infertility services, sexually transmitted infection and HIV testing, breast and cervical cancer screenings and pregnancy testing and counseling.

The Title X grant program began in 1970 "from a growing recognition of the effects of unintended childbearing on poverty levels… The basic function of Title X is to fund family-planning services for people who are unable to pay for them," the lawsuit said.

One in four women will have an abortion by age 45.

ON THE RECORD

"Because of the administration's overreach and interference in healthcare decision making, physicians will be prohibited from having open, frank conversations with their patients about all their healthcare options. This blatant violation of patients' rights under the Code of Medical Ethics is untenable," said AMA President Dr. Barbara L. McAneny. "The new rule imposes a government gag rule on what information physicians can provide to their patients." 

Catherine Glenn Foster, president and CEO of Americans United for Life said since its beginning, "Title X has excluded elective abortions from its grant program, reflecting the commitment of the majority of Americans not to have their hard-earned tax dollars subsidize Planned Parenthood and other members of the abortion industry. HHS's new regulation makes this rule clearer for everyone involved, and its terms have already been upheld by the Supreme Court during the Reagan Administration. It's a 'win-win' all around, so naturally, only Planned Parenthood and its apologists could object to it."

WHAT ELSE YOU NEED TO KNOW

States involved in the lawsuit include California, Oregon, New York, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

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