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‘More Than an Undue Burden’: Trump’s Domestic ‘Gag Rule’ Faces Flurry of Lawsuits

Dennis Carter

Officials in 21 states are slated to bring lawsuits against the so-called domestic "gag rule," expected to go into effect in early May.

The Trump administration’s attack on access to family planning for people with low incomes, known as the domestic “gag rule,” drew a series of legal challenges this week.

The anti-choice policy would prove devastating for health-care clinics across the United States, advocates say. In Maine, the rule would shut down 85 percent of the state’s abortion clinics, according to the Center for Reproductive Rights, leaving large swaths of the state without access to legal abortion care.

The Center for Reproductive Rights and Maine Family Planning—the state’s sole recipient of the Title X family planning funds targeted by the administration—on Wednesday filed the latest lawsuit against the recently finalized rule. Officials in 21 states are slated to bring lawsuits against the “gag rule,” expected to go into effect in early May. Pro-choice advocates see the rule as a backdoor attempt to defund Planned Parenthood—a longstanding goal of anti-choice activists and Republican lawmakers.

The anti-choice policy bans Title X money from going to health-care providers who refer patients for abortions and requires clinics to physically separate Title X-funded family planning services and abortion services.

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Such a requirement would eliminate abortion services at 17 of the 18 family planning centers operated by Maine Family Planning, said George Hill, the organization’s president and CEO, during a Wednesday press conference announcing the latest legal action against the domestic “gag rule.” This would delay care for many, and abortion services would be “out of reach altogether” for those in rural parts of Maine who have no other access to health care.

“Abortion should not be stigmatized the way the Trump administration is trying to do,” Hill said. 

Satisfying the physical separation requirement would require excessive costs, forcing many clinics to stop offering abortion care if they continue to receive Title X funding, said Emily Nestler, senior staff attorney at the Center for Reproductive Rights and lead attorney on the case.

“It’s more than an undue burden,” Nestler said during Wednesday’s press conference. “It’s prohibitive.”

The Trump administration’s domestic “gag rule,” similar to a policy pushed by the Reagan administration, would bar health-care workers at Title X clinics from talking to pregnant people about abortion care, Nestler said. That would hold true even if a pregnant person came to a Title X clinic asking for an abortion referral. “Frankly it makes no sense on its face,” she said.

Hill said the domestic “gag rule” could make reproductive health-care centers operate like anti-choice pregnancy centers, which don’t offer patients a full range of reproductive care and often lie to pregnant people seeking abortion care.

Maine Family Planning has received Title X funding for most of the 50 years the program has been around, using that federal funding to provide affordable birth control, STD testing, and cancer screenings to people across the state, including those in isolated rural areas near the Canadian border and in Maine’s mountainous western region. Title X clinics provide health-care services for 4 million people with low incomes in the United States.

Title X grant program was designed to equalize access to contraceptive health care as part of the federal government’s war on poverty

“The program is doing exactly what it is supposed to do,” Hill said, adding that Title X has led to Maine having one of the highest contraceptive usage rates in the United States. Maine has the highest “proportion of women at risk of unintended pregnancy who report use of highly effective long-acting reversible contraceptive,” according to the Guttmacher Institute. 

Evelyn Kieltyka, senior vice president of program services at Maine Family Planning, said during the press conference that the Trump administration’s gag rule “inserts politics into the exam room,” and could “force us to mislead and stonewall our patients” seeking abortion services. 

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