Defunded: New Trump admin rule to cut Planned Parenthood subsidies by almost $60M

Donald Trump likes to remind people about how often he keeps his promises. Pro-lifers have new reason to agree after the administration issued a final draft on a new HHS rule that could cut $60 million from Planned Parenthood’s haul at the federal trough. The new Title X regulation bars reimbursements to any facilities that perform abortions or formally refers women to abortion facilities:

President Donald Trump today finalized an administrative rule that would partially defund the Planned Parenthood abortion business and deprive it of as much as $60 million in taxpayer dollars. This action adds to President Trump’s record of defunding the Planned Parenthood abortion company.

The abortion chain receives about $50 million to $60 million in Title X funds annually, but that could change now that the new rules are being implemented. The administration’s changes to Title X family planning grants have angered the abortion chain Planned Parenthood, prompting a lawsuit, but they provide hope for life-affirming pregnancy centers, which can now compete with the abortion giant for the federal funds. …

Last May, the Trump administration published a new proposal for Title X that would prohibit Planned Parenthood and other abortion businesses from receiving any of those tax dollars unless they completely separate their abortion businesses from their taxpayer-funded services. That mean housing their family planning services in separate buildings with separate staff from their abortion businesses and a denial of funds if they fail to do so. Most Planned Parenthood entities are not expected to comply.

Under the new directive, which will take effect in 60 days, organizations receiving Title X funding have 120 days to financially separate their family planning and abortion operations and one year to physically separate their family planning and abortion operations.

That would amount to a partial defunding of Planned Parenthood, anyway. It’s about as far as the White House can go without action from Congress. This new rule change has been in the works for some time; while activists would have preferred a fast-track change, the administration apparently felt more secure in ensuring that every administrative jot and tittle was in place first. After getting burned on several other abrupt regulatory changes in court, the White House had good reason to make sure that these changes were as bulletproof in court as possible.

They will soon get a chance to find out whether that effort was successful. Democrats and abortion advocates pledged to challenge the rule as soon as it goes into effect. Their focus fell on the restrictions for referrals, which they called a “gag rule”:

Washington Sen. Patty Murray, the ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, said in a statement that the rule aimed to “further undermine a woman’s constitutionally protected right to safe, legal abortion.”

“Under this rule the doctors and providers who millions of women trust — disproportionately women of color and women who rely on clinics for affordable care — will be blocked from offering them the full range of medically sound reproductive health options because politicians in the White House think they know better,” Murray said. “Well, my message is that extreme Republicans absolutely do not know better than women about women’s health care, and we are going to make sure we are heard.”

Senate Minority Leader Chuck Schumer, D-N.Y., called the rule a “gag on health providers that strongly hinders their ability to work with women to determine the best health care decision.”

“It imposes radical Republican views on American women by strategically putting obstacles in the way of accessing the health care they deserve,” he said.

“Gag rule” is at best an overstatement. The new rule does not bar discussion of abortion as an alternative in counseling funded by Title X dollars. Rather, it no longer requires counselors to discuss abortion as an alternative. The new rule does bar counselors from promoting or supporting abortion “as a method of family planning” and to refer patients for that purpose, but it specifically allows “nondirective counseling on abortion.” That still won’t satisfy critics, but the difference may be enough to satisfy courts.

Politico’s Alice Miranda Ollstein smells the aroma of 2020 coming from both parties on this issue. Democrats have vowed to fight this issue in appropriations bills, but their options are pretty limited. Just as Trump and Republicans never did have the votes to defund Planned Parenthood in the previous Congress, Democrats don’t have the votes to ramp up their subsidies through other means either:

House Democrats could try to redirect Title X funds to Planned Parenthood and abortion clinics through an annual appropriations bill, but the Republican majority in the Senate has signaled they will reject those efforts and President Donald Trump has already vowed a veto. Well aware of this dynamic, senior House Democratic aides said the caucus isn’t likely to wage a fruitless battle on the issue if that would mean risking another government shutdown later this year. …

The strategy falls short of the sweeping overhaul of abortion rights that the Democratic Party’s most progressive members promised in their health care-centric fight to take back the House in 2018. Still, lawmakers insist they’ll explore all the legislative tools now available to them — including hearings and subpoenas — to push back against not just the Title X rule but any legislation or policy rider that would impose new abortion restrictions.

The political stakes are just as high for Republicans, who during the last two years failed to fulfill their base’s demands to defund Planned Parenthood, pass a 20-week abortion ban or significantly curtail abortion rights, despite having full control of Washington.

As for the courts, that route does not look promising either, Ollstein writes:

The rule will be challenged in court, and precedent is on the Trump administration’s side. The Supreme Court upheld similar funding restrictions in 1991, but they were never fully enacted before the Clinton administration rescinded them the following year.

And so this tees up the fight for 2020. Whichever party controls the White House will determine whether these restrictions remain or vanish.

The point most of this misses, of course, is that this has no impact at all on the funding levels of Title X. The money is there; it’s just that abortionists can no longer get reimbursements through it. While that might put a big dent in the for-profit operations of Planned Parenthood, it opens up a market for non-abortion clinics to serve the family-planning needs of women across the country. Planned Parenthood has crowded out entrants into that market until now, thanks in large part to the big bite they took out of Title X. Women will almost certainly be better served by the emergence of such clinics which do not have financial incentives to sell abortions as the primary method of family planning.