Dear Secretary Azar,
We urge you to review and update the regulations governing the Title X Family Planning Program to ensure program integrity with respect to abortion. Section 1008 of the Public Health Service Act clearly states that no federal funds appropriated for Title X for family-planning services "shall be used in programs where abortion is a method of family planning." However, the program's current regulations (42 CFR 59) undermine the law.
Specifically, the current Clinton-era regulations require grantees to refer pregnant women for abortion (42 CFR 59.5(a)(5)(i)(C)) and allow Title X clinics to co-locate with abortion clinics-in some cases utilizing the same waiting rooms, staff, and facilities. Title X programs which are co-located with abortion clinics or refer for abortion send a message that abortion is considered a method of family planning in federally-funded family planning programs, contrary to the law.
We ask that you restore the regulations issued on February 2, 1988 (53 FR 2922), which clarified that Title X programs may not promote, counsel, or refer clients for abortion or collocate or combine family planning services with abortion activities. These rules required not only complete financial separation, but also physical separation of abortion activities from Title X service sites and separate personnel. These rules were upheld by the Supreme Court in Rust v. Sullivan, 500 U.S. 173 (1991).
We applaud the states that have acted on Congress' 2017 legislation overturning an Obama-era Title X rule (P.L. 115-23) by redirecting these funds from abortion entities like Planned Parenthood towards community health centers that provide more comprehensive health services for women, but not abortion. Nevertheless, we urge the administration to do more.
Therefore, we request swift action to issue new regulations for the Title X program. These new regulations should ensure program integrity by requiring a robust and complete separation of abortion activities from federally funded family planning activities. Any programs failing to achieve this standard should not receive federal funding.