On Monday, the Trump Administration was poised to publish its long-threatened changes to Title X (10), the nation’s family planning program, established in 1970 by a bipartisan Congress and President Richard Nixon. Since its inception, Title X has been a bedrock, cost-effective public health program ensuring that low-income and uninsured individuals have access to critical family planning care, including contraception, annual exams, STD testing and treatment, and screenings for breast and cervical cancer.
Now, the new Title X rule inserts abortion politics into what has historically been a program intended to equalize access to contraception and preventive healthcare. To advance an ideological agenda, the new rule intentionally upends what has been a governing principle in the program for nearly 50 years— that patients’ choices and health care needs come first. It replaces the patient’s right to accurate and complete health care information with anti-contraceptive, anti-abortion coercion.
The rule blatantly disregards patient autonomy, eliminating the longstanding ethical requirement that pregnant patients be given factual, nonbiased counseling and information on all pregnancy options. In fact, it requires all pregnant patients be referred for prenatal care, even if they do not wish to continue the pregnancy.
The rule gags health care providers, forbidding them from referring patients for abortion care, even when asked. This inserts the government into what should be a private health care decision, undermines the trust patients place in their medical provider, and undercuts the high-quality care and respect patients have come to expect from Title X providers.
The new Title X rule also seeks to force out providers like Boulder Valley Women’s Health Center, who offer abortion care using non-Title X funds. While this rule may have been designed to target abortion providers, it has far-reaching implications for all Title X providers and for the ability of patients to receive the confidential family planning and sexual health care services they seek.
The people most harmed by these sweeping changes will be the individuals who rely on Title X for their health care — people struggling financially, people of color, adolescents, and others who are marginalized or without resources — the same populations most vulnerable to unintended pregnancy and its consequences.
Here in Colorado, the Title X program has been life-changing for thousands of low-income people, particularly teens. Administered through the state network of Title X clinics, the Colorado Family Planning Initiative provided free IUDs and implants from 2009 to 2014, resulting in an astounding 50 percent drop in the teen birth and abortion rates, averting nearly $70 million in public assistance costs, and empowering thousands of young women to postpone starting families until they were ready.
If our nation’s family planning programs crumble, patients will no longer be able to get the care they need from providers they trust. The impact will be increased rates of unintended pregnancies and STDs, reversing decades of investment, commitment, and progress in these areas.
At Boulder Valley Women’s Health Center, we know the crucial role that affordable and confidential reproductive health care services make in people’s lives. When people can take charge of their sexual and reproductive health, they are able to create the futures they desire. As the first abortion clinic in the state of Colorado, established in 1973 just months after Roe v. Wade, we have been at the forefront of providing comprehensive reproductive health care for decades. We intend to keep being here for those who need us most.
Susan Buchanan, RN, JD, is the executive director/CEO of Boulder Valley Women’s Health Center.
