WASHINGTON – The Biden administration on Wednesday began to undo a Trump-era ban on clinics referring women for abortions, a policy that drove Planned Parenthood from the federal family planning program and created new complications for women trying to get birth control.
The proposed rule from the Department of Health and Human Services follows through on President Joe Biden's campaign promise to reverse his predecessor's family planning policy, which was branded a “gag rule” by women's groups and decried by medical associations as violating the doctor-patient relationship.
But the Biden administration stopped short of immediately suspending the Trump regulation, which went into effect in 2019. While some abortion rights advocates had sought that additional step, administration officials believe that moving carefully and deliberately will increase the odds of the proposed changes being upheld in court.
Known as Title X, the federal family planning program has been in place for 50 years. It makes available about $286 million annually in grants that support clinics serving mainly low-income women. Those clinics, which provide birth control and basic health care services, have been whipsawed by Trump-era battles over ideology and by the impact of the coronavirus pandemic on health services providers. Before exiting the program in 2019, Planned Parenthood and its affiliates served an estimated 40% of the patients.
Though by law federal family planning money could not be used to pay for abortions, religious conservatives long regarded the program as a form of indirect subsidy to Planned Parenthood, the nation's largest provider of abortions. Former President Donald Trump counted on religious conservatives as a cornerstone of his political base and acceded to their demands on a range of women's health issues.
Besides banning abortion referrals, his administration required federally funded clinics to financially and physically separate themselves from facilities that provide abortions. Abortion counseling was designated as an optional instead of a standard practice, and limits were placed on which staff members could discuss abortion with patients, among other requirements. Pregnant women were supposed to be referred for prenatal counseling even if they did not want it.
The Biden administration estimated that as a result of the Trump policy changes, the program serves about 1.5 million fewer women a year, a 37% reduction from the average caseload from 2016-18. HHS also estimated that the Trump policies may have led to up to 180,000 unintended pregnancies.
The department said its proposed rule reversal will restore the program to how it ran under President Barack Obama, when clinics were able to refer women seeking abortions to a provider.