The Title X Gag Rule Is Already Drastically Affecting Low-Income Patients in America

Supermajority Education Fund

February 12, 2020

In 2019, the Trump administration passed a new gag rule that prohibited doctors whose organizations received funding from the Title X program from providing abortions or referring their patients for abortions. On February 5, the Guttmacher Institute reported that since the gag rule went into effect last February, Title X national family planning patient capacity has been slashed in half. That means that 1.6 million patients, or 47 percent of the population that was previously receiving contraceptive care through Title X, now can’t receive care. 

Title X, a federally funded program that was enacted under the Public Health Service Act in 1970, provides comprehensive and confidential family planning and preventative services to low-income people in the U.S. Per Physicians for Reproductive Health, the program is implemented through more than 3,500 clinics in the nation, including public health departments and non-profit health centers. 

But according to findings from the Kaiser Family Foundation and Power to Decide, an estimated 1,000 U.S. clinics that spanned across 18 states have left the Title X program since 2019, likely as a result of the gag rule. Guttmacher notes that the clinics provided healthcare for half of the patients served by the program nationally. In several states — including Hawaii, Maine, Oregon, Utah, Vermont, and Washington — Title X funding has been reduced by 100 percent, and the entire network of Title X clinics no longer receives funding from the program. In Connecticut, Illinois, Maryland, New York, and Wisconsin, Title X funding has been reduced by 90 to 99 percent. 

Ruth Dawson, Guttmacher Institute Senior Policy Manager and Title X expert told Supermajority News that reproductive health advocates were aware of the effects that the gag rule would have on clinics and patients in the U.S.: “We have known from the start that the Title X gag rule is a horrendous policy, deliberately designed to undermine affordable birth control access. But now we have an estimate of the true damage being done—and it’s devastating,” she said. 

Dawson added that it’s important for Americans to understand that this Title X gag rule is part of a larger plan on the current administration to make changes to the healthcare industry for the entire country. Republicans under the Trump administration have made big changes to the Affordable Care Act (ACA) and made cuts to Medicaid; Dawson said the restrictions on contraceptive care are in line with the rest of those healthcare decisions. 

“It is important to contextualize the attack on Title X in the larger conservative agenda to cut reproductive health care and health care writ large,” Dawson said. “The Title X gag rule on its own is callous and harmful and taken together with actions to gut the ACA, chip away at Medicaid, and undermine the ACA’s contraceptive coverage guarantee, paints a chillingly comprehensive picture of just how intent the administration is on eliminating people’s ability to get affordable birth control.”