Trump administration defends controversial changes to family planning program on Capitol Hill

The Trump administration faced fierce backlash from Democrats Wednesday when it defended its controversial decision to ban abortion providers from participating in a federally funded family planning program.

Deputy Assistant Secretary for Population Affairs Diane Foley, a Trump appointee, testified before Congress for the first time Wednesday about the administration’s changes to Title X, a decades-old grant program for family planning clinics that offer contraception and preventive health services to low-income women.

{mosads}The rule, which has been lauded by anti-abortion groups as a way to cut federal funding to Planned Parenthood, requires clinics that receive Title X funds be financially and physically separated from any abortion services and prevents providers from referring women for abortions.

It has been temporarily blocked by two federal judges in a lawsuit filed by Planned Parenthood and the American Medical Association.

Foley argued the new rule is necessary because the administration has “grave concerns” Title X funds could be misused for abortions but was unable to tell Democrats if the administration had any proof of this happening. Though clinics that receive Title X funding may also provide abortions, there is a decades-old ban on federal funding being used for the procedure, with rare exceptions.

“We all know Title X funds don’t go to abortion, it never has, and you can’t give us one violation of that statute, one example of Title X funds going to abortion,” Rep. Raul Ruiz (D-Calif.) said to Foley during the Oversight and Investigations subcommittee hearing.

“That fear is unfounded.”

When asked if there was any evidence Title X providers have illegally used the funds for abortions, Foley responded, “There is great concern that co-location increases the opportunity for co-mingling of funds.”

The separation requirements would affect 10 percent of providers, Foley said. Clinics would either have to make changes to comply with the rules or leave the program. 

The changes also block Title X providers from referring women for abortions, and lifts a requirement that providers counsel women on abortion as an option.

Foley said those changes are intended to bring Title X in line with federal law. She said the counseling requirement violated the “conscience rights” of groups that wanted to participate in the Title X program but oppose abortion.

“There are many providers that avoid being part of the Title X program because the current regulations states that are required to refer for abortions and required to have counseling,” she said.

But she maintained that the changes don’t prevent doctors from having honest discussions with patients about their options and said providers “are free to provide counseling on all the options, including the options of abortion,” as long as it is non-directive counseling that is not intended to influence the patient’s decision.

Abortion referrals would still be allowed when medically necessary, or if the pregnancy was the result of rape or incest.

But Democrats were testy with Foley, arguing that the changes were ideologically motivated and part of the Trump administration’s anti-abortion agenda.

“This is about trying to limit women from having their full reproductive rights,” Rep. Jan Schakowsky (D-Ill.).

The rule is also opposed by many health organizations, including the American College of Obstetricians and Gynecologists, which argues it will put patients at risk of losing access to care.

“If the rule is implemented, all Title X providers would be forced into only bad choices: withhold critical information and limit care to patients or leave the program and be less able or unable to care for low-income people in their community,” Clare Coleman, president of the National Family Planning & Reproductive Health Association,  told lawmakers Wednesday.

Anti-abortion groups, however, note the rule wouldn’t cut funding for Title X, but instead fund clinics that are willing to follow the new rules.

“The Protect Life Rule simply draws a bright line between abortion and family planning, stopping abortion businesses like Planned Parenthood from treating Title X as their private slush fund without reducing funding by a dime,” said Susan B. Anthony List President Marjorie Dannenfelser.

“Abortion is not health care, and we can better serve women and families by redirecting tax dollars to the growing network of community health alternatives that outnumber Planned Parenthood facilities at least 20 to one.”

Republicans also widely support the rule.

“I am concerned about program integrity issues within the Title X program and that some grantees may not be always using funds in a way that is consistent with the statutory intent,” said Rep. Brett Guthrie (R-Ky.), the subcommittee’s top Republican.