At issue is $286 million in federal spending under the Title X program, which funds clinics for low-income women seeking contraception, prenatal care, disease screenings and the like. Consistent with Congress’s long-standing policy against direct taxpayer funding of abortion, Title X stipulates that none of its funds “shall be used in programs where abortion is a method of family planning.” Decades of wrangling in the courts and regulatory agencies have attempted to attach practical meaning to that amorphous phrase.
In 1988, as an election-year sop to the antiabortion movement, President Ronald Reagan adopted regulations that barred Title X grantees from not only providing abortions but also advising patients about pregnancy termination. The Supreme Court upheld that rule in 1991, rejecting doctors’ claims that it violated their right to free speech; but it never was fully carried out, mainly because a new, pro-choice president, Bill Clinton, took office soon after the litigation ended.
President George W. Bush never even attempted to reinstate the Reagan rule, which gives you some idea how far in the other direction Mr. Trump is now pushing. Still, even he would not go all the way back to 1988. Apparently, his proposal would prohibit actual referrals for abortion services while permitting neutral counseling about abortion,
as opposed to requiring it, which is the current rule.
That’s mostly a symbolic shift. Far more consequential is the administration’s apparent intention to toughen requirements that abortion and other services be carried out by entities that are separate not only financially but physically. Entities that also provide abortion would receive no Title X money, while all others would remain eligible. Proponents say this would enable government to “disentangle” abortion from other services; and no doubt this would impose additional administrative and operational burdens on Planned Parenthood, as the antiabortion movement intends.
Of course, another way to look at that is that anything that makes life harder for Planned Parenthood and threatens its funding also makes life harder for its clients. Planned Parenthood says it serves approximately 41 percent of women who get Title X-funded family planning services. These women tend to be lower-income people with few readily available alternatives. (Planned Parenthood serves the majority of clients who use publicly supported contraceptive services in about 8 percent of the United States’ 3,141 counties.) If they cannot get access to contraception, they will be more likely to have unwanted pregnancies. And unwanted pregnancies often end in abortion.