Letter to the Hon. Alexander Azar, Secretary of Health and Human Services - Chairman Crowley, Sens. Warren, Murray, and Hassan and Reps. Barbara Lee and Nita Lowey Oppose Title X Domestic Gag Rule

Letter

Dear Secretary Azar,

We would like to express our support of the Title X family planning program and our strong opposition to any plans to reinstate the "domestic gag rule," which imposes restrictions on Title X providers and restricts access to affordable, quality, and lifesaving health care in communities across the country.

As you know, Title X is the only federal grant program dedicated to providing family planning services to low-income and otherwise underserved individuals. Each year, Title X offers roughly four million women and men confidential, medically accurate, and evidence-based care. With services ranging from cancer screenings to well-woman exams, Title X providers ensure their patients receive the highest standard of medical care. As every federal dollar invested in Title X saves Medicaid more than seven dollars, this is also a program that taxpayers can--and do--believe in.

In keeping with longstanding legal, ethical, and medical standards of health care, Title X providers offer patients medically accurate counseling on and referrals for all pregnancy options--including parenting, adoption and abortion. The Title X program has never funded abortion services at its health centers, and health centers that receive Title X funds to provide family planning care may also separately provide abortions using non-federal funds.

In spite of the critical role that Title X plays in promoting the health and well-being of millions of people, President Trump has indicated he plans to dramatically reduce its reach by reinstating the "domestic gag rule." This rule would prevent health care providers from receiving Title X funding if they even mention abortion or abortion-related services to their patients. The domestic gag rule would effectively restrict the ability of patients to receive medical counseling on abortion and make informed decisions about their own reproductive health. On top of the ban on counseling and referrals, the 'gag rule' would impose additional requirements intended to bar providers from participating in Title X that also separately provide abortion services. This would have a devastating effect on the millions of Americans who rely on Title X for basic health needs, and it would have a particularly disproportionate impact on low-income individuals and communities of color.

Reinstating the domestic gag rule is nothing more than an opportunity for President Trump to fulfill his pledge to "defund Planned Parenthood," whose health centers serve 40 percent of Title X patients and remain an essential part of the family planning safety net. Additionally, other providers of Title X-funded care would face immense challenges in attempting to absorb the patients that would lose access to care through Planned Parenthood.

Finally, a "domestic gag rule" could reverse progress made in critical areas. Primarily, unintended pregnancy rates in the U.S.--including those among teenagers--have been declining.[1] In 2015 alone, the contraceptive services supported by Title X helped women avoid 822,000 unintended pregnancies, which would have resulted in 387,000 unplanned births and 278,000 abortions. Cutting access to eligible providers would only pare back access to contraceptive services.

We strongly oppose efforts to undermine the integrity of the Title X program and harm the millions of people who rely on it for care. Federal health policy should be evidence-based and produced with the best interests of patients in mind. It should not be the result of the political whims of a partisan campaign pledge.

Sincerely,