Health care in a bind

Trump's proposed restrictions on Planned Parenthood threaten to curtail care in towns with a doctor shortage

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By Mark Guarino

A new Trump proposal to impose restrictions on abortion has raised the ire of Planned Parenthood and other reproductive-rights organizations that characterize it as a thinly veiled attempt to galvanize conservative voters for the midterm elections in November.

It especially threatens to curtail health care for women in communities across Illinois that have little or no immediate access to traditional doctors.

President Trump announced the proposal at a gala late Tuesday for the Susan B. Anthony List, a national anti-abortion organization. “I pledged to stand for life, and as president, that’s exactly what I’ve done,” he said.

The proposal, submitted last week to the U.S. Department of Health and Human Services, targets family-planning programs that receive federal funding from Title X — the statute that created the federal family-planning program. Among the new rules are that doctors, nurses, hospitals, and community health centers can no longer provide a woman information about abortion providers unless she specifically states she decided to terminate her pregnancy. Clinics that receive federal money would no longer be allowed to provide the procedure.

According to Planned Parenthood's 2016 annual report, the most recent one of its kind available, it operates 16 locations in 10 cities in Illinois. Nine of the 16 locations serve areas that are federally designated as having a shortage of primary-care providers.

On Wednesday, Planned Parenthood characterized the proposal as a “gag rule” because it prevents medical providers from giving their patients the full slate of information about their services or health care.

“This is a day American women thought they would never see, and I don’t believe they will stand for it,” said Dawn Laguens, Planned Parenthood’s executive vice president.

In a call with reporters, Laguens said the severity of the proposal will make it “fail miserably,” and she added that it is outside the bounds of what American women want.

Survey data from Hart Research Associates in Washington show that the majority of both Americans (73 percent) and American women (77 percent) oppose policies that make it illegal for health-care providers to refer or counsel women about the option of abortion. Three in four Americans (75 percent) object to any attempt to block access to care at Planned Parenthood health centers.

Hart Research President Geoff Garin said that the numbers skew higher for women under 40. “Through words and deeds, the Trump administration has already branded itself in minds of young women voters that it is hostile to women’s access to reproductive health care,” he said. “This new action will only add to the intensity of that threat.”

The survey took place during the first two weeks of May among 1,807 adults, including oversamples of African Americans and Hispanics.

The American Medical Association also came out in opposition to the new rules.

"The AMA objects strongly to the administration’s plan to withhold federal family-planning funding from Planned Parenthood and other entities. We are particularly alarmed about government interference with the patient-physician relationship in the exam room," said AMA President David Barbe. "High-quality medical care relies on honest, unfiltered conversations between patients and their physicians. Gag orders that restrict the ability of physicians to explain all options to their patients and refer to them — whatever their health-care needs — compromise this relationship and force physicians and nurses to withhold information that their patients need to make decisions about their care."

Barbe emphasized that the threat was particularly acute in poorer communities, saying, "The Title X program ensures that every person — regardless of where they live, how much money they make, their background, or whether or not they have health insurance — has access to basic, preventive reproductive health care." He said it serves 4 million people each year, "many of whom would otherwise be unable to access this health care."

Emily Stewart, Planned Parenthood’s vice president of public policy, said the potential restrictions for Title X participants will be particularly harsh for low-income people since the program targets providers that offer a range of services, including birth control and cancer screenings, to people who are uninsured or underinsured. Planned Parenthood carries the heaviest burden for that population, providing care to 41 percent of Title X patients while they account for only 13 percent of federal funding.

“The new changes are clearly designated to fundamentally dismantle the national program for affordable birth control,” she said.

She said that currently no Title X funding is allocated for abortion services at Planned Parenthood.

According to Barbe, Title X is popular, successful, and has had bipartisan support for decades, and it has produced results, with U.S. figures at a 30-year low for unintended pregnancy and a historic low for pregnancy among teenagers. "We should not be walking that progress back," he added.

Laguens said that Planned Parenthood is organizing a rally late Wednesday on Capitol Hill and on Thursday will play host to rallies at Health and Human Services regional offices across the country, including Chicago. She added that the organization “will explore every option, including litigation” as more about the proposals become known.