National Family Planning Program in for a Major Shake-Up

Title X is a super important public health program that provides folks with comprehensive family planning and related preventive health services. It's designed to prioritize the needs of low-income families or uninsured people. The overall purpose is to promote positive birth outcomes and healthy families by allowing individuals to decide the number and spacing of children.

The services provided by Title X grantees (the funding comes from the federal government) include family planning and contraception, education and counseling, breast and pelvic exams, breast and cervical cancer screening, screenings and treatment for sexually transmitted infections and HIV.  It also focuses on counseling, referrals to other health care resources, pregnancy diagnosis, and pregnancy counseling. Title X funding does not pay for abortions.

Back in March of this year, the US Department of Health & Human Services published in the Federal Register a final rule making changes to the federal regulations governing the Title X national family planning program. The final rules dramatically change the existing Title X family planning program nationally and in AZ.  The changes include:

  • Eliminating Title X’s long-standing legal and ethical requirement for non-directive pregnancy options counseling; and

  • Requiring a “bright line” of physical and financial separation between the provision of family planning and abortion services.

Numerous provider groups, state attorneys general and non-profit organizations sought an injunction after the new Rules were announced (seeking an injunction to stop the rule from taking effect while the courts decide the legality of the rule). 

Legal History of the Case

Multiple federal district court judges blocked the new restrictive rules from going into effect. On June 20, 2019, a three-judge panel of the 9th Circuit Court of Appeals granted the Administration’s request to lift the preliminary injunctions, allowing the new Title X rules to be enforced. In early July, the 9th Circuit court ordered the cases be reheard en banc (meaning by all the judges on the 9th circuit versus a three-judge panel).

On July 11, the en banc court refused to block the new Title X rules from taking effect.

So, what’s the bottom line then?  For now- the new April Title X Rules that eliminate Title X’s long-standing model of offering non-directive pregnancy options counseling, and requiring a “bright line” of physical and financial separation between the provision of family planning and abortion services stand. 

Title X grantees including the Arizona Family Health partnership received notice from HHS that they must certify that they comply with the new regulations by September 18.  The plans for how they intend to comply were due Friday August 18.

What remains to be seen is what happens to the family planning network after September 18.  If Planned Parenthood decides to no longer provide Title X because of the new Rules, there would be a big gap in the network and folks that usually get their family planning services via Title X would need to find other places to go for these services. Since other providers are likely booked up- that means there cojld be some pretty significant delays in getting appointments for family planning services.