Title X: Federal Funding for Crisis Pregnancy Centers

By Stephanie Verdoia, Legal Voice summer intern

In March, the Trump administration issued new rules to the Title X program that funds family planning services for people with low incomes. These changes forced Planned Parenthood to withdraw from the program last month, which will result in limiting health care access for low-income communities across the country. But there is another problem with the new rules; they will redirect federal money to organizations that don’t provide the full range of care for patients and refuse to inform patients of all the birth control options available to them.

Since the 1970s, crisis pregnancy centers, sometimes called “limited service pregnancy centers,” have been posing as walk-in medical clinics for family planning and pregnancy-related care. These so-called “clinics” claim to provide comprehensive medical care by saying in their advertisements that they offer “evidence-based medical care” and “all options pregnancy counseling.”  Their staff often wear white coats or scrubs and perform quasi-medical services like pregnancy testing and ultrasound examinations, although they often have no medical education or training, and thus no business diagnosing anything. The clinics provide information about contraception and abortion that is false or misleading — all for the purpose of delaying a pregnant person’s decision-making process until it is too late to terminate the pregnancy. What is particularly alarming is that there are far more crisis pregnancy centers across the country than there are legitimate reproductive health clinics.

In recent years, some crisis pregnancy centers have begun offering medical services beyond pregnancy tests and ultrasounds, though they still refuse to counsel patients about birth control (other than the rhythm method) or abortion, or provide referrals for these services — even at the request of their patients.

The new Trump rules enable these more “medicalized” CPCs to apply for Title X funding by relaxing the old requirement that the grant recipients provide comprehensive care to their patients, including the full range of FDA approved contraceptives. This means that people who rely on Title X clinics for healthcare may receive less than comprehensive information and care.  Instead, patients’ medical treatment options will be tailored to align with an extremist politic agenda.

Before the Trump Administration issued these new rules, clinics that received federal funding were required to offer all options to the pregnant person without promoting one option over another, a practice called non-directive counseling. Grantees also were required to offer the full range of “medically-approved” family planning services, including contraception options.

The new rules prohibit abortion referrals, even in medically urgent situations and green lights funding for grantees that offer no family planning options other than fertility awareness-based methods (basically the rhythm method), which have a higher risk of pregnancy than birth control pills or the IUD.

Of course, this will cause the greatest harm to those who most rely upon the Title X program for their basic reproductive healthcare needs, including women with low incomes, women of color, young women, and LGBTQ people. Over 4 million low-income, uninsured, and underserved clients have relied on the Title X program for almost fifty years.

Although more than 20 states and the American Medical Association are challenging the new regulations in court, many low-income communities already feel the impact of the changes. Planned Parenthood served 40% of Title X recipients, and in states with no backup funding, delays and higher costs in services are already occurring.

Patients seeking family planning services deserve to understand all of their options-- regardless of their socio-economic status. Individual autonomy in medical decision making is a fundamental liberty that the federal government should protect - not undermine.  These regulations ensure that only the most privileged of our society will continue to enjoy access to the care they seek.