On April 15, 2021, the U.S. Department of Health and Human Services (HHS) published a proposed rule on the Title X family planning program that would reverse the Trump Administration’s 2019 Title X Rule (also known as the “Protect Life Rule”).
On May 4th, the USCCB along with the Southern Baptists Convention’s Ethics and Religious Liberty Commission, the Catholic Medical Association, the National Association of Catholic Nurses-USA, and The National Catholic Bioethics Center submitted joint comments pointing out several problems, including that the proposed rule would reintegrate abortion into what Congress intended to be a pre-pregnancy family planning program.
Congress created Title X of the Public Health Service Act (Title “Ten”) in 1970 as a pre-pregnancy federal family planning program to help poor women limit and space their family size. It was created in the heat of the population control movement and receives millions from the federal government every year. Embedded in the authorizing law itself is a strict prohibition on abortion.
Nevertheless, Executive Branch guidelines governing the early years of the program soon required abortion referrals, non-directive abortion counseling, and allowed abortions to be performed in the same location, allowing the program to become a direct channel for abortion providers to receive clients as well as federal money. To respond to this abuse, President Reagan issued regulations in 1987 requiring that Title X service sites be physically and financially separated from abortion centers, and not refer or counsel for abortion, and further clarified that single method providers may be funded. These regulations were challenged and successfully defended by the George H.W. Bush Administration in the U.S. Supreme Court case Rust v Sullivan (1991). However, the regulations were rescinded in January of 1993 under President Clinton whose administration issued new regulations later that year requiring abortion referrals and allowing co-location of Title X clinic sites with abortion sites. The Clinton regulations were in place until February 2019 when President Trump finalized new rules similar to the Reagan/Bush era regulations again separating abortion from family planning.
The Biden Administration’s proposed rule, if finalized, would allow the Title X program to again become an indirect funding avenue for abortion providers. Despite explicit prohibitions in Federal law and clear congressional intent that abortion not be a part of this program, it has repeatedly been coopted by abortion supporters as a funding stream for organizations, programs, and facilities that directly promote and provide abortions. While USCCB has always had strong objections to government promotion and funding of contraceptives, it has also long supported clear financial and physical separation between Title X-funded projects and programs and facilities where abortion is a method of family planning and has objected to abortion referrals in the Title X program.