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Title X Gag Rule and Women’s Health Services on Campus

Title X Gag RuleOfficials from the Department of Health and Human Services (HHS) announced that they would be revoking requirements from organizations that receive Title X funding to counsel women about abortion and provide them with referrals to abortion services, last Friday, Feb. 22. 

Under the new rules, a provider would not have to talk about abortion as an option at all. Women’s health organizations, including Planned Parenthood, which would be directly affected by this ruling), the American College of Obstetricians and Gynecologists (ACOG), and Physicians for Reproductive Health have spoken out against the policy.

Currently, the Title X program provides federal funding for facilities that offer family planning and other preventive services, especially those that serve lower-income patients.

In its official statement, the HHS would require “financial and physical separation” between facilities and programs that provide services funded through Title X grants and those providing abortions.

However, Title X funding was never allowed to directly fund abortion services, and due to the controversial Hyde Amendment, federal Medicaid funding is prohibited from covering abortion costs, with exceptions of rape or incest. 

The Trump administration’s latest provision, deemed by many as a “gag rule,” could mean that a clinic cannot even receive Title X funding for the necessary health services they provide, such as providing access to affordable birth control methods that would prevent unwanted pregnancies, if they also offer abortions or answer their patient’s questions about abortion referrals. 

“A Title X project may not perform, promote, refer for, or support, abortion as a method of family planning, nor take any other affirmative action to assist a patient to secure such an abortion,” the policy states.

The one exception is if a woman “clearly states that she has already decided to have an abortion.”

In this situation, a doctor or other provider should provide “a list of licensed, qualified comprehensive health service providers (some, but not all, of which also provide abortion, in addition to comprehensive prenatal care.)”

The Monmouth University Health Center offers no cost medical exams and ambulatory services to students and eligible employees by board-certified Nurse Practitioners, including affordable women’s health services. Although it does not receive any grants from Title X funding, the Health Center is an example of the kinds of facilities the gag rule would affect.  

Kathy Maloney, DNP, APN, Director of Health Services, said that revoking Title X funding will narrow the options available for patients seeking care in facilities that do receiving grants.

“We always ask the women if they have thought about what they might want to do. Depending upon the answer, we provide them with local resources.  If they are undecided, we refer them to counseling,” Maloney explained.

The following services are provided as part of the University’s Women’s Clinic: prescribed birth control pills, free pregnancy testing, gynecological exams, pap testing, breast exams, STD testing and screening, and treatment for urinary tract infections (UTI).

Such services would potentially be affected in facilities that do receive federal Title X funding under the order if they also perform or refer patients to abortion services.

“Women’s Clinic is a broad term and refers to episodic gynecological women’s services in addition to well-women’s care,” said Maloney. Last year, Health Services provided more than 750 women-related services. 

Title X is legally designed to prioritize the needs of low-income families or uninsured people who might not otherwise have access to these health care services, including those who are not eligible for Medicaid. These services are provided to low-income and uninsured individuals at reduced or no cost. 

The services provided by Title X grantees include family planning and provision of contraception, education and counseling, breast and pelvic exams, breast and cervical cancer screening, screenings and treatment for sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV), education about preventing STIs and HIV and counseling for affected patients, referrals to other health care resources, pregnancy diagnosis, and pregnancy counseling.

IMAGE TAKEN from Planned Parenthood