The Trump Administration Is Bringing the Global Gag Rule Home

The Trump administration is expected to announce the implementation of a domestic gag rule on Friday, the New York Times reports. The domestic gag rule, which has been a top priority for anti-abortion conservatives in the administration, would prevent reproductive healthcare providers like Planned Parenthood from accessing Title X funds if they provide abortion referrals. The domestic gag rule language is still unclear since it hasn’t been officially released, but it could mirror the global gag rule Donald Trump reinstated in January 2017, through an executive order.

“This is a far-reaching attack and an attempt to take away women’s basic rights and reproductive rights,” Dawn Laguens, executive vice president of Planned Parenthood Federation of America (PPFA), said on Friday. “I would posit that a president who it’s clear does not know the difference between HIV and HPV should not be interfering in the doctor-patient relationship,” she added.

Healthcare providers are already barred from using Title X funds for abortion services, but anti-abortion conservatives have long rallied their base by arguing, contrary to federal law, that organizations like Planned Parenthood offer abortions at taxpayer expense. That sentiment was echoed on Thursday when Marjorie Dannenfelser, president of the Susan B. Anthony List, a conservative anti-abortion group, thanked Donald Trump for “taking action to disentangle taxpayers from the abortion business.” In a statement, she described the decision as a “major victory” that would “energize the grassroots as we head into critical midterm elections.”

Planned Parenthood, however, contends that the domestic gag rule is a targeted attempt to undermine services provided by the organization, purposefully preventing them from providing care to already underserved patients. Roughly 1.6 million of the 4 million Title X patients access reproductive healthcare solely through Planned Parenthood. Beth Lynk, associate director of communications at PPFA, noted to Jezebel that the number of patients Planned Parenthood serves through Title X is much larger since the organization partners with smaller groups and clinics who are unable to provide the full range of birth control options, like IUDs.

During his campaign, Trump promised constituents that he would defund Planned Parenthood, forcing the organization to separate its Title X-funded family planning work from its abortion care. Mike Pence reiterated that promise in January when, during a speech at the March for Life, he promised that the administration would end “taxpayer funding for abortion and abortion providers,” adding that “we will devote those resources to health care services for women across America.”

Though that promise initially seemed more rhetorical than actual, Trump, whose recent embrace of anti-abortion politics is more opportunistic than convicted, seems to have taken cues from anti-abortion advisors inside the administration. Those include Kellyanne Conway who, Axios reported in April, pressured him to “follows through on his campaign promises to end federal funding for Planned Parenthood—with the money redirected to Women’s Qualified Health Centers—so long as the organization continues performing abortions.”

Armed with information on organizations that could ostensibly offer Title X-related care, provided by the Charlotte Lozier Insitute, the research arm of the conservative anti-abortion women’s group Susan B. Anthony List, Conway attempted to demonstrate that excluding Planned Parenthood from the federal grants program would have little impact on the quality of reproductive care. But, as Molly Osberg reported in early May, organizations listed by the Lozier Insitute included “schools, dental clinics, nursing homes, and even homeless shelters.”

As Planned Parenthood sees it, preventing access to reproductive care is the very intention of the Trump-Pence administration, and this forthcoming announcement is a gag rule. “If the intent behind [Title X] is to ensure that people have access to the full range of reproductive healthcare options, removing Planned Parenthood from the program undercuts that goal,” Lynk said. “The safety net is not set up to deliver those services,” she added.

The domestic gag rule is part and parcel of the Trump administration’s reshaping of Title X, one that has consistently eroded access to the full range of reproductive services. In mid-February, the Department of Health and Human Services rolled out new guidelines for Title X applicants that opened the door to funding for abstinence-only programs and natural family planning as well as anti-abortion crisis clinics. Those guidelines, Lynk said, “were a complete remake the Title X program as we know it.” In response, Planned Parenthood filed a lawsuit against the Trump administration, arguing that the new guidelines would place the health of millions of patients at risk by prioritizing what HHS calls “Fertility Awareness Based Methods” (family planning that does not involve contraceptives or barrier methods) over comprehensive services.

The new Title X guidelines “stacked the deck against Planned Parenthood,” Lynk said, emphasizing that they give funding priority to abstinence-only providers. “A woman in her 30s is going to a health center and be directed toward achieving a ‘sexually risk-free status,’ which is abstinence,” Lynk pointed out. “Or she’s being told to get married instead of getting access to the care she needs.”

The domestic gag rule would go even farther, effectively removing Title X funding from Planned Parenthood and organizations like it unless they agreed to no longer provider referrals to healthcare workers who can provide an abortion. “It undermines medical ethics by forcing health care professionals to withhold accurate and timely medical information from patients,” Dr. Jenn Conti, fellow with Physicians for Reproductive Health, said in a statement. “The government should be protecting Title X—a program designed to make sure that every person has access to basic, preventive reproductive health care,” Conti added.

Carrie Flaxman, deputy director for public policy litigation for PPFA, said that that Planned Parenthood has “an unwavering commitment” to its patients, adding that the organization “will do everything to fight for our patients.”