The Trump administration posted a final rule Friday that would require family planning clinics to be housed in separate buildings from abortion clinics, a move that would cut off Planned Parenthood from some federal funding.
The rule applies to a $286 million-a-year grant, known as Title X, that pays for birth control, testing of sexually transmitted diseases, and cancer screenings for 4 million low-income people. It requires the “physical and financial” separation of family planning services and abortion.
Federal funds are not permitted to go toward abortions except in the cases of rape, incest, or if a woman’s pregnancy threatens her life. Abortion foes, however, have long fought for rules along the lines of the one advanced Friday because they say allocating federal funds toward clinics such as Planned Parenthood frees up additional funds to provide abortions. The organization receives between $50 million and $60 million from Title X.
Planned Parenthood vowed to do everything it could to fight back, including through the courts.
“Planned Parenthood will fight the Trump-Pence administration through every avenue so this illegal, unethical rule never goes into effect,” said Dr. Leana Wen, Planned Parenthood’s president, speaking to reporters on a press call.
The organization said the requirements would force its facilities to build separate entrances and exits, construct new health centers, or hire a second staff of doctors, nurses, and administrative staff.
The rule takes effect 60 days after it is published in the Federal Register but clinics will have a year to comply with the new building requirements.
Planned Parenthood, which covers roughly 40 percent of people who use Title X to get medical services, has drawn criticism from the Trump administration because it provides abortions. Republicans in Congress have failed to cut off funding from Planned Parenthood, leaving anti-abortion groups to rely on the White House to advance their causes.
The rule does not defund all of Planned Parenthood, as some Republicans have called for, because the organization gets other government funding. Separately from government funding, it receives donations as well as reimbursement for services by insurers. The rule would, however, either force facilities to make major changes or forgo tens of millions of dollars.
The rule would also block providers from referring for abortions for the purpose of family planning or promoting the practice if they are receiving Title X grants. Critics have often referred to it as a “gag rule.”
“Imagine if the Trump administration prevented doctors from talking to our patients with diabetes about insulin,” Wen said in a statement after the rule came out. “It would never happen. Reproductive health care should be no different. Reproductive health care is healthcare and healthcare is a basic human right.”
The Trump administration has denied that the proposal would prevent doctors from counseling women about abortion.
One of the main purposes of the proposal is to shift federal funds from Planned Parenthood and other organizations that provide abortions to community and rural health centers, or otherwise pressure Planned Parenthood and other facilities to stop providing abortions.
The Family Research Council, an organization that opposes abortion, praised the rule and said Trump has “been persistent in fulfilling his pro-life campaign promises.”
“Planned Parenthood and other abortion centers will now have to choose between dropping their abortion services from any location that gets Title X dollars and moving those abortion operations offsite,” Tony Perkins, the group’s president, said in a statement. “Either way, this will loosen the group’s hold on tens of millions of tax dollars.”
The rule is similar to a 1988 policy instituted by former President Ronald Reagan, which required family planning services to have a “physical separation” and “separate personnel” from abortion providers.
Planned Parenthood and other groups challenged the Reagan-era rule in court. The Supreme Court allowed the policy to move forward, but it was never carried out completely. Then-President Bill Clinton rolled back the rules in 1994.
“We don’t believe this is less extreme than the Reagan rule,” Carrie Flaxman, deputy director of public policy litigation and law at Planned Parenthood, said in the call with reporters. “It does the same things that rule did… Congress has been very clear that rules like this one cannot be imposed.”
The Trump administration announced late last year that it would be giving family planning grants to 11 Planned Parenthood facilities, but did not specify the amount for the grants. Wen suggested to reporters that Planned Parenthood would consider no longer participating in Title X if the rules stay in place, saying her organization was committed to providing abortions, but stressed the first course of action would be to fight back.
“We have encountered countless attacks on our ability to provide reproductive healthcare to our patients,” she said. “This is just one more attack.”