Biden begins reversing Trump-era abortion ban

WASHINGTON (AP) — The Biden administration on Wednesday began reversing a Trump-era ban on clinics referring women for abortions, a policy that pushed Planned Parenthood out of the federal family planning program and created new complications for women trying to achieve birth control.

The Health Department’s proposed rule follows President Joe Biden’s campaign pledge to reverse his predecessor’s family planning policy, which women’s groups have branded as a “gag rule” and condemned by medical associations as a violation of the doctor-patient relationship.

But the Biden administration did not immediately suspend the Trump executive order, which went into effect in 2019. While some abortion law advocates had sought that extra step, administration officials believe that proceeding cautiously and deliberately will increase the chances that the proposed changes will be upheld in court.

Known as Title X, the federal family planning program has been in existence for 50 years. It provides approximately $286 million annually in grants that support clinics that primarily serve low-income women. These clinics, which provide birth control and essential health services, have been hurt by ideology struggles during the Trump era and the impact of the coronavirus pandemic on health care providers. Before leaving the program in 2019, Planned Parenthood and its affiliates served an estimated 40 percent of patients.

Although federal family planning funds were prohibited by law from being used to pay for abortions, religious conservatives have long viewed the program as a form of indirect subsidy to Planned Parenthood, the nation’s largest abortion provider. Former President Donald Trump counted on religious conservatives as the cornerstone of his political base and joined their demands on a range of women’s health issues.

In addition to banning abortion referrals, his government has required federally funded clinics to divest themselves financially and physically of facilities that perform abortions. Abortion counseling was designated as optional rather than standard practice, and limits were placed on staff who could, among other things, speak to patients about abortion. Pregnant women should be referred for pregnancy counseling even if they don’t want to.

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The Biden administration estimated that the program is serving about 1.5 million fewer women per year as a result of Trump policy changes, a 37 percent reduction from the average caseload of 2016-18. HHS also estimated that Trump policies may have resulted in as many as 180,000 unwanted pregnancies.

The department said the proposed rule reversal will return the program to the state it ran under President Barack Obama, when clinics could refer women seeking an abortion to a provider.

“Ultimately, continued enforcement of the 2019 rule opens the possibility of a two-tier health care system where those with insurance and full access to health care receive full medical information and referrals, while low-income populations with fewer care options are pushed back to inferior access,” HHS said in a statement. “This situation creates widespread public health concerns.”

Planned Parenthood President Alexis McGill Johnson said her organization could rejoin the program sometime next year if the Biden rule is finalized as expected. According to HHS, clinics that left the program will gradually return, and Title X should be serving about 4 million customers again within a few years.

McGill Johnson said Biden must not only restore the program, but improve it. “What’s most important is some kind of double commitment to really provide expanded access to care,” she said in an interview.

The release of the proposed rules was the government’s second crackdown on anti-abortion advocates this week. On Tuesday, the Food and Drug Administration said that for the duration of the coronavirus pandemic, women are not required to visit a doctor’s office to get a prescription for an abortion pill and can safely rely on telemedicine instead.

The head of a national group campaigning for anti-abortion elections said the government rewards Planned Parenthood for its political support. “Following Biden’s FDA refusal to enforce safety rules on dangerous abortion drugs and Biden’s efforts to undermine the Supreme Court, their latest push to save the abortion industry proves there isn’t a rule they wouldn’t rewrite or just ignore around to prevail,” Marjorie Dannenfelser, president of the Susan B. Anthony List, said in a statement.

But the American Medical Association welcomed the postponement, saying Trump policies “inadequately interfered with the patient-physician relationship and jeopardized safe access to reproductive care.”

The rule reversal regarding family planning clinics continues in tandem with a lawsuit over Trump administration policies that is now before the Supreme Court. In that case, the judges agreed to hear a challenge to the rules, which Biden is now trying to unravel. The Biden administration and medical groups that filed the challenge are asking the court to dismiss the case, but Republican attorneys general want to go ahead. The court has yet to say what it will do.

The 1970 law that created the family planning program stipulated that taxpayers’ money should not be used “where abortion is a method of family planning.”

Proponents and opponents of abortion rights have debated for decades whether counseling a patient about abortion or referring a patient to another provider for an abortion violates that language. Abortion remains a legal medical procedure, although increased access to contraception has led to a significant decline in recent years.

The Biden administration’s rule must go through an announcement and comment period and additional review before it’s final, which could take several months.

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