Central PA's LGBT News Source
If you’re not familiar with terms like Title X or gag rule (which is most readers), why should you care if family planning funds are changed, cut, or eliminated?
“The gag rule would set up a two-tiered system of family planning care,” says Patricia Fonzi, CEO, Family Health Council of Central PA (FHCCP).
If enacted, the gag rule, “would undermine our ability to provide referrals and information about abortion services, posing a threat to the doctor-patient relationship,” says Karen McCraw, Vice President of Advocacy and Development, FHCCP.
What are the current threats to Pennsylvania’s funding for family planning?
Right now, there are two clear and present threats to Family Planning funding - a refocus of program priorities and the so-called gag rule, according to Fonzi. All Federal Family Planning funding, known as Title X, is subject to a competitive grant process. The last round ended in May and the focus of the grant requirements presents a threat, Fonzi says.
“In previous competitions, provider experience, areas of need, a wide range of contraceptive options, and science-based methods were prioritized for funding,” Fonzi explains.
In the May round of grant applications, “the word ‘contraception’ was not mentioned once in a 60-page document,” Fonzi points out, “yet the phrase ‘fertility awareness methods’ (meaning natural family planning, the rhythm method or abstinence) was mentioned over 10 times. This reflects the administration’s new priority – to fund faith-based crisis pregnancy centers and to limit access to health information.” In other words, she explains, if organizations want Federal funding, they must agree to prioritize non-science-based methods of contraception and not even mention the word abortion, even when information is requested.
The language distinction is important.
Organizations such as FHCCP could lose funding because of the emphasis on what Fonzi calls the inclusion of unqualified, non-medical providers in the family planning network. Although FHCCP includes natural family planning methods in their list of services, Fonzi says most women who ask for services request information on contraceptive methods that include long-acting reversible methods such as IUDs and implants as well as hormonal methods such as pills and injections.
“Grantees will no longer be required to offer the full scope of family planning services, but instead could offer just one service, such as natural family planning,” clarifies Karen McCraw, Vice President of Advocacy and Development, FHCCP. This means. McCraw says, that the clinic you visit may or may not be required to tell you what services they offer or how they are limited by faith-based tenets in what types of “contraception” they offer.
In addition, the newly proposed guidance (guidance is language the Federal government publishes to advise potential grantees) mentions what is called the “gag rule”. If enacted, the gag rule, McCraw says, “would undermine our ability to provide referrals and information about abortion services, posing a threat to the covenant of the doctor-patient relationship”.
The proposed guidance drastically alters how family planning and related services are viewed, McCraw says, noting that access to even basic information such as a phone number or a name of a provider who performs abortion would be prohibited. “Imagine if any other type of medical provider were censored regarding what they could talk to their patients about, we would never stand for it,” McCraw says.
Generally, the funding guidelines new focus exclude contraceptive methods other than natural family planning. Coupled with the possible adoption of the gag rule on abortion, as well as other nuances in the 110-page document “creates a two-tiered system of care where low-income and uninsured women and men who currently rely on Title X for health care would not have access to the same level of service and information as their insured counterparts,” Fonzi says.
Federal vs. State
“Threats to family planning are coming from the Federal level,” Fonzi says. “We’re lucky to have the strong support of Governor Wolf.” Although the pressure today comes from Washington, “Pennsylvania’s state legislature would love nothing more than to de-fund Planned Parenthood.” Fonzi says.
Fonzi zeroes in on the Trump Administration and its appointees to explain the shift in funding guidelines.
“The Trump Administration and his appointed staff at the Department of Health and Human Services are promoting a religious and cultural agenda. That agenda is being applied to funding of family planning services,” Fonzi says.
The funding shift and the headlines it creates “gives fuel to the 2018 mid-term elections and acts as a lead up to the 2020 general election,” Fonzi calculates. “They want to talk more about restricting access to abortion rather than the original legislative intent of the Title X program. The original objective of Title X is to empower people to plan their families and provide them with the tools they need. Access to family planning care is the best way to reduce the number of unplanned pregnancies and abortions.”
“Unfettered access to reproductive health services has allowed women and men to further their education, join the work force, and become empowered to make choices that give them more control over their lives,” McCraw says. “Some people are uncomfortable and threatened by these changes in our society.”
Who’s affected by funding cuts?
“Low-income, uninsured or underinsured individuals,” McCraw says. “Those most in need of confidential, low-cost services, and individuals who experience barriers to care (LGBTQ, adolescents, rural residents), would not have many other options, and they are the vast majority of Title X clients.”
Is there a Perception vs. Reality problem regarding the shift in funding priorities?
“Those seeking to drastically change the system are not using data or science for their arguments,” Fonzi says. McCraw agrees. “The proposed rule makes it sound like the vast majority of women want to use natural family planning and are not receiving instruction in that method,” she says.
“In reality, Title X-funded sites already offer instruction in ‘fertility awareness’ methods to any woman who requests it,” McCraw says. “People choose methods of contraception based on many factors, but mainly because they are effective and medically approved.”
Fonzi says “The methods they want to fund are not nearly as effective as other methods, but they will quote ‘data’ that says otherwise.
What’s the bottom line for Fonzi and McCraw who lead an organization serving 24 Pennsylvania counties?
“It’s all about the ‘gag rule,’” Fonzi concludes.
If the rule is adopted, the change would mandate the fiscal and physical separation of abortion services and Title X activities. “That separation requirement goes way beyond the current Pennsylvania Abortion Control Act,” McCraw says.
In other words, to cut through the Geek talk – the gag rule “would prohibit a Title X-funded provider, like FHCCP, from doing ‘options counseling’ for women who request it,” McCraw says. The change would “prohibit discussing abortion, giving women who request them referrals for an abortion, or having a flyer available which would have contact information for abortion services”.
“Those with resources - financial, educational, a knowledgeable network would be able to get the full range of reproductive health services, including abortion. Women who lack those resources would not have access to the full range of reproductive health services,” Fonzi concludes.