Clare Coleman, CEO of the National Family Planning and Reproductive Health Association, talks with NPR’s Sarah McCammon about recent changes to Title X regulations.

SARAH MCCAMMON, HOST:

Family planning clinics around the country that provide health services to low-income Americans have been getting some mixed messages recently from the federal government. This past week, the Trump administration said it would immediately begin enforcing new rules for the Title X family planning program, which would eliminate funding to organizations that provide or counsel patients about abortion. Then this weekend, we learned that Trump administration officials are now saying they will not immediately take action against groups deemed to be working in good faith to comply.

Clare Coleman is the CEO of the National Family Planning and Reproductive Health Association, which represents family planning clinics around the country. She joins us now.

Welcome.

CLARE COLEMAN: Thank you. It’s nice to be here.

MCCAMMON: So first, let’s talk about Title X. What is its role in providing reproductive health services, and how is the Trump administration trying to change the program?

COLEMAN: Well, the Title X program is now in its 49th year, and it was established to equalize access to modern forms of contraception and to help people both achieve pregnancy and prevent pregnancy. Last year, the Trump administration introduced a new set of rules, which represent the most consequential changes to the Title X program since it was enacted in 1970.

It changes the rules around how we can speak to patients about their contraceptive care. It allows providers to select the range of contraceptive methods that are offered and would allow providers to exclude methods that they object to, even if patients are interested in those methods. And it also limits the conversation that clinicians can have with patients once they have a positive pregnancy test.

MCCAMMON: Now, President Trump and other Republicans have run on promises to, quote, unquote, “defund Planned Parenthood.” This policy change is an effort to move in that direction, not just for Planned Parenthood but for other groups, of course. Now, the objection – I covered this issue quite a bit, and the objection from anti-abortion rights groups is that they say that funding for abortion should in no way be commingled or overlapping with other services. And so I would ask, why couldn’t these groups just stop providing abortions or referring patients for abortion?

COLEMAN: Well, the Title X program has prohibited use of Title X dollars for abortion care since its inception, and current grantees and some recipients follow very detailed rules that help you demonstrate when you have Title X funds that support family planning services, STI treatment and screening, cancer screening and then any abortion care that is provided in the same organization. Those rules go down to the very detail of financial reporting, and our grantees report quarterly. The administration has not been able to document either in the rule, in testimony before Congress or in any public documentation that there is any abuse whatsoever of the prohibition on Title X funds.

MCCAMMON: And what does this mean for the patients?

COLEMAN: It can be very confusing. And, candidly, it may be invisible. But I think for many low-income people, they know exactly how much cash they have in the bank, but they’re not necessarily tracking the rules. And one of our great fears is that folks are going to begin to encounter this when a service that used to be available to them is suddenly not available, or they’re presented suddenly with a bill.

So I’m concerned, and I think lots of us are concerned that all the decisions and considerations and guidance and coming back and forth between the feds and additionally the litigation that continues that patients won’t really begin to feel the impact until they ask for something that is no longer available to them where they live.

MCCAMMON: Clare Coleman is the CEO of the National Family Planning and Reproductive Health Association.

Thank you so much.

COLEMAN: You’re welcome. It’s my pleasure.

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