Trump’s Title X Rule Is Much More Than a Gag Rule

On June 1, the Trump administration issued a proposed rule that would drastically change Title X, the nation’s program for affordable birth control and reproductive health care. Trump’s rule not only prohibits family planning providers from referring patients for abortion care, but it also instructs Title X providers to offer intentionally confusing information if a patient requests an abortion referral. This delay tactic makes it even more difficult for people to access timely abortion care.

Under the proposed rule, when a patient asks for an abortion referral, a Title X provider could only give out a list of health care providers that includes both those that do provide abortion care and those that don’t. The list wouldn’t identify abortion providers in any way. The patient would have to figure out where to go.

For a patient who hasn’t clearly stated “that she has already decided to have an abortion,” her Title X provider would only be allowed to share a list of providers who don’t offer abortion care, including prenatal care providers. In fact, the proposed rule requires Title X clinics to refer this type of pregnant patient (those who haven’t specifically asked for an abortion) to prenatal and/or social services and to assist with setting up the referral appointment “to optimize the health of the mother and unborn child.” 

These requirements would exacerbate the impact of existing state- and federal-level abortion restrictions that already make it difficult for patients — especially those under 18, those with low incomes and people of color — to obtain timely abortion care. In many states, particularly in rural areas, finding a nearby abortion provider can be very challenging. Targeted regulation of abortion providers (TRAP) laws, such as hospital admitting privilege requirements and building standards, have led to clinic closures across the country. With fewer clinics providing abortions, more women must travel longer distances for abortion care. According to the Guttmacher Institute, 27 percent of women aged 15-44 would have to travel at least 30 miles. They face extra financial hardships, such as paying for transportation, overnight accommodations, childcare and lost wages from missed work (if they don’t have paid sick time). And these are just the costs associated with getting to the clinic. 

Insurance coverage restrictions -- such as the Hyde Amendment (which restricts federal funding for abortion except in cases of life endangerment, rape and incest) — increase the out-of-pocket costs for the abortion itself. Waiting periods (which require people seeking abortion care to wait 18 to 72 hours between her pre-abortion consultation and the actual procedure or medication process) can further complicate the challenges of obtaining a timely abortion. All these barriers and built-in delays could push a person beyond her state’s gestational limit for abortion, making it no longer an option.

Trump’s rule and the deliberately confusing health care provider list would create another hoop for people seeking abortion care to jump through to exercise their constitutional right to a safe and legal abortion.

Urge your members of Congress to co-sponsor and support resolution H.Res.915 in the House and S.Res.526 in the Senate. These resolutions make clear that the proposed Title X restrictions would erode the patient-provider relationship and prevent patients from receiving care.