President Trump has announced he will restore a Reagan-era regulation forbidding clinics in the federal Title X family planning program to perform or refer for abortions.
Planned Parenthood, promising a lawsuit, describes this policy as “preventing patients from visiting Planned Parenthood health centers,” and commentators on both sides of the issue call it an effort to “defund Planned Parenthood.”
The reality is somewhat different. A little perspective is needed.
According to a 2016 fact sheet by the Guttmacher Institute, a former Planned Parenthood affiliate, the federal government spends well over $2 billion a year on family planning, mostly through Medicaid (not affected by the regulation). Title X makes up less than 15 percent of the total.
Planned Parenthood receives over half a billion dollars in taxpayer funds annually, about $80 million of it from Title X. The organization performs over one-third of all abortions in the country, and abortion is what it provides to 96 percent of its pregnant clients.
So what did a Democratic-controlled Congress say about abortion when it created the Title X program in 1970?
It overwhelmingly approved an amendment, already unanimously approved in committee, requiring that no Title X funds “shall be used in programs where abortion is a method of family planning.”
The amendment remains in place today. It is not merely a ban on direct use of federal funds to perform abortions, though many news outlets misrepresent it that way. Its sponsor, Democratic Rep. John Dingell of Michigan, said its intent is that “abortion is not to be encouraged or promoted in any way through this legislation.”
Rep. Dingell gave three reasons for this policy. First, there is a basic ethical difference between preventing a pregnancy and taking the life of an unborn child. Second, the purpose of a family planning program should be to “reduce the incidence of abortion,” not increase it. Third, evidence indicated that “the prevalence of abortion as a substitute or a backup for contraceptive methods can reduce the effectiveness of family planning programs.”
Today, there is substantial evidence that family planning programs often do not reduce abortions. But even politicians supporting “abortion rights” have said abortion should be “rare.” And obviously facilitating abortion does the opposite of reducing abortions.
So the regulation defunds no one. But if an organization receives Title X grants at some sites, it must locate its abortion business elsewhere. Planned Parenthood will have to adjust its business model. Since 2013, it has required every affiliate to have at least one site perform abortions. The idea was that the affiliate’s other sites can receive Title X funding, and still send 96 percent of their pregnant clients to the affiliated abortion clinic.
Planned Parenthood says the regulation to close this loophole is “a vicious, new and unprecedented attack on reproductive health care.” But it is not new or unprecedented. It seems more modest than the Reagan regulations upheld by the U.S. Supreme Court in 1991, which barred Title X clinics from counseling on abortion as well as from performing or referring for it. The new rule is said not to restrict counseling.
As for “vicious attack,” Planned Parenthood tends to see any lack of enthusiasm for abortion that way.
A word of caution to pro-life groups tempted to exaggerate what the regulation does. Wild exaggeration is Planned Parenthood’s specialty, to whip up outrage among supporters. Its alert on the regulation urges them to “add fuel to the fire.”
In today’s polarized climate, more fire is not what we need. The regulation will better implement what Congress always intended in this program. Once upon a time, everyone knew that’s what federal regulations are for.
Doerflinger worked for 36 years in the Secretariat of Pro-Life Activities of the U.S. Conference of Catholic Bishops. He writes from Washington state.
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