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Title X & The Gag Rule

Title X: America’s ONLY federal funding program for family planning services.

Title X is the nation’s federal funding program for family planning services. For more than 40 years, this program has played a critical role in ensuring access to a broad range of family planning and related preventive health services for low-income or uninsured individuals. Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. Title X funding already CANNOT be used for abortion services. The program is overseen by the Department of Health and Human Services’ Office of Population Affairs (OPA).

In 2017, OPA provided $13,502,000 for services for 200,562 patients in Pennsylvania. Pennsylvania’s Planned Parenthoods make up 13% of the 191 PA health centers that participate in Title X, but served 36% of patients in 2016.

Gag Rule

The domestic gag rule essentially prohibits health care providers in the United States from discussing abortion with their patients if they receive Title X Family Planning Program money.

The domestic gag rule announced on May 22, 2018 includes:

  • blocking access to care at Planned Parenthood under Title X;

  • prohibiting Title X providers from referring for abortion; and

  • removing existing Title X protections that ensure women have full, honest information about all of their pregnancy options, including abortion.

  • deleting the requirement that contraceptive methods provided by Title X projects be “medically approved.”

  • stating that Title X projects do not have to provide every effective and acceptable method of family planning.

After the announcement, there was a 60 day comment period from June 1st- July 31st, 2018. Over 490,000 individual comments were submitted opposing the gag rule. Beyond this, more than 200 members of Congress, 13 Attorneys General,  80 mayors, 274 state legislators, 60 celebrities, and EVERY major medical association came out against it.

On July 17th, 2018, the Pittsburgh City Council signed a Will of Council denouncing the gag rule stating:

NOW, THEREFORE BE IT RESOLVED that the Council of the City of Pittsburgh does hereby oppose the United States Department of Health and Human Services’ proposed rule changes to Title X and the harmful effects of a lack of basic healthcare and services that stem from these changes; and BE IT FURTHER RESOLVED that the Council of the City of Pittsburgh hereby urges the Department of Health and Human Services to study the public’s support of family planning services and to take steps to provide access to all forms of reproductive health information and services without information bans.

The Department of Health and Human Services is currently reviewing the public’s comments and will eventually be announcing their final version of the rule. Once this happens, there is a 60 day waiting period before it is enacted.

On February 22nd, the Department of Health and Human Services announced the finalized gag rule. The finalized gag rule is essentially the same as what was originally announced in May of 2018. Planned Parenthood Federation of America’s legal experts are right now pouring over the final gag rule to find the best options for litigation. Remember, the Reagan administration tried to implement a gag rule, but it was held up in the courts and later retracted by the Clinton administration. We will update this section once these legal options come to light.

Despite the gag rule, PPWP’s doors stay open at all of our health centers. Soon after the announcement of the Title X Gag Rule in May, PPWP has been working with our supporters to help establish a temporary gap fund that would provide the resources needed so that we can limit the harmful impact of this policy and ensure that anyone in need can continue to have access to affordable services at PPWP.

Key facts about Title X and Planned Parenthood:

  • According to latest estimates, Planned Parenthood health centers from around the country served four in 10 Title X patients (41 percent) in 2015, despite only accounting for 13 percent of Title X centers.

  • More than half of Planned Parenthood’s health centers are located in medically underserved areas.

  • Research has shown that Planned Parenthood consistently outperforms other publicly funded providers, including FQHCs, when it comes to meeting the family planning needs of people across the United States by:

    • Providing the full range of birth control methods on-site;

    • Filling longer-term contraceptive prescriptions; and

    • Offering shorter wait times and expanded health center hours.

  • Community health centers will not be able to fill the huge void if Planned Parenthood is blocked from Title X program, dealing a major blow to health care access for thousands of low-income people across the country.

  • Community health centers themselves say there is no way they could fill the gap if Planned Parenthood health centers were no longer allowed to serve these patients.

  • The idea that other providers could absorb Planned Parenthood’s patients has been resoundingly dismissed by experts. In fact, Dr. Georges Benjamin, the executive director of the American Public Health Association, called the idea “ludicrous."

  • Across the entire community health center network, nearly half of sites served fewer than 10 contraceptive patients annually.

  • In fact, many of the lists of “replacement” providers don’t even provide reproductive health care. In Louisiana, the state list of alternative providers included dentists and nursing homes. In Florida, it included school nurses. In Ohio, it included food banks.


More Information:

National Family Planning & Reproductive Health Association: The Title X Family Planning Program in Pennsylvania September 2018

National Family Planning & Reproductive Health Association: The Title X Family Planning State Snapshot Pennsylvania October 2018

Guttmacher Institute: Beyond the Rhetoric: The Real-World Impact of Attacks on Planned Parenthood and Title X August 2017

Guttmacher Institute: A Domestic Gag Rule and More: The Administration’s Proposed Changes to Title X June 2018

Guttmacher Institute: Ensuring Adolescents’ Ability to Obtain Confidential Family Planning Services in Title X November 2018

Kaiser Family Foundation: New Title X Regulations: Implications for Women and Family Planning Providers March 2019


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