A Trump administration official overseeing the Title X family planning program on Wednesday dismissed congressional concerns that the domestic “gag rule” prevents providers from offering information about abortion and could hinder access to care.
The U.S. House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing Wednesday on the administration’s Title X policy
with testimony from a Trump official and representatives of both pro-choice and anti-choice advocacy groups.
The hearing comes nearly four months after the administration finalized the Title X restrictions, dubbed the domestic “gag rule” by reproductive rights advocates. Though blocked by the courts, the rule would ban health providers receiving Title X funding from making abortion referrals and force abortion providers to physically and financially separate abortion services from family planning to receive the funding.
“Anti-abortion ideology is fueling the administration’s actions,” Rep. Diana DeGette (D-CO), chair of the oversight committee, said in her opening statement. “Using Title X funds to provide abortions has been and is currently statutorily prohibited,” she added.
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“In fact, the administration cannot point to a single instance in the program’s entire history where Title X funds have been misapplied for this purpose,” she said. “Efforts to curb abortion providers’ participation in the Title X program is a solution in search of a problem. This rule is the administration’s absurd effort to equate abortion referral as tantamount to the actual provision of abortion services.”
Diane Foley, deputy assistant secretary for population affairs at the U.S. Department of Health and Human Services (HHS), defended the administration’s restrictions on Title X. “It is not a gag rule,” she said, adding that patients can be referred for abortions in cases of rape, incest, and life endangerment. Before she joined the Trump administration to lead the office that oversees the Title X program, Foley was the president and CEO of Life Network, an organization that operates two anti-choice crisis pregnancy centers in Colorado.
Rep. Raul Ruiz (D-CA), a physician, questioned Foley’s claim that the restrictions were not a gag rule. “One of the provisions in the final rule prohibits Title X providers from referring their patients for abortion services, even if specifically requested,” Ruiz said. Giving the example of a pregnant teenager who visits a clinic in hopes of getting an abortion referral, Ruiz asked Foley whether a doctor could provide that patient with the requested information.
Foley replied that providers could not give information about abortion as a form of family planning under the administration’s rule. But she said the rule “does not prohibit” providers from having “non-directive” conversations with patients about the options available to them—as long as the counseling is “client-directed based on the questions they are asking.”
Dr. Leana Wen, president and CEO of Planned Parenthood Federation of America, pushed back against Foley’s claim that the administration’s anti-choice restriction on Title X didn’t constitute a “gag rule.”
“This is a government gag rule on what information physicians, like me, can provide to our patients and would censor us from providing patients information about where and how they can access all their health care options,” Wen said in a statement to Rewire.News.
“The American Medical Association has said that the Title X gag rule violate patients’ rights in the Code of Medical Ethics. We should not treat reproductive health care any differently than any other aspect of health care. This gag rule is direct interference by the government in health care decision-making—it would allow politicians to prevent physicians and nurses from fulfilling the oath we took to serve our patients.”
Foley faced questions in the hearing about whether some providers would be forced to leave the Title X program or to shut their doors if the administration’s anti-choice restrictions go into effect.
Rep. Joe Kennedy (D-MA) said Foley had provided “zero evidence” there had ever been “co-mingling” between clinics’ Title X-funded family planning services and abortion services—the stated reason for the rule’s requirement of physical and financial separation. Foley replied that those clinics’ “choice to close” was not made by HHS.
Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association (NFPRHA), testified about ways the administration’s rule undermines the Title X program. “If the rule is implemented, all Title X providers in every single location would be forced into only bad choices: they can withhold critical information and limit care to patients or they can leave the program and be less able or unable to care for low-income people in their community,” Coleman said in the hearing. “This rule shows no respect and no regard for the millions of poor and low-income people who today rely on Title X for their primary, and often only, health care.”
“These attacks are wholly unwarranted and they’re unjustifiable,” she said.