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E&C Democrats Demand Administration Justify Title X Gag Rule

March 1, 2019

Washington, D.C. – Energy and Commerce leaders sent a letter to Health and Human Services (HHS) Secretary Alex Azar demanding evidence and justifications for the Trump Administration's final Title X gag rule, which threatens the program's provider network and its patients' access to care. The letter was signed by Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Health Subcommittee Chairwoman Anna G. Eshoo (D-CA), and Oversight and Investigations Subcommittee Chair Diana DeGette (D-CO).

"We have serious concerns regarding the final rule's compliance with the Title X statute, the public health implications of this action, and the Administration's rationale for these changes," the Committee leaders wrote to Azar. "Additionally, we have questions about the Department's expansive claim of authority under this rule, HHS's failure to account for the significant costs created as a result of the final rule, and the internal regulatory process used by the Department to review and finalize this rule."

The Title X family planning program is a federal grant program intended to provide individuals with quality family planning and related health services. The Trump Administration's gag rule prohibits Title X grant recipients from referring their patients for abortion services, even when requested by a client. The rule also requires Title X projects to have strict financial and physical separation from any "activities that fall outside the program's scope," which is intended to ensure family planning providers that offer abortion services are not eligible to receive Title X funds.

The Committee leaders continued, "The success of Title X is largely due to the network of qualified family planning providers that have implemented the program's goals since its creation. It is disturbing that the Administration has chosen to undermine the ongoing success of this program by finalizing this rule."

As part of their inquiry into the Administration's rationale behind the Title X gag rule, the Committee leaders are requesting answers to a series of questions, including:

  • Does HHS have evidence to justify the physical separation requirements included in the Title X rule?
  • What evidence did HHS rely on in making an exception to include adoption as a postconception care Title X service, but not the other options previously covered under the statute?
  • Why did HHS not take into account the economic impact on Title X patients, such as the lack of access to previously available health care services, which public health experts have said could result from the final rule?
  • Given that this rule clearly adversely affects public health, why did the Administration not choose to consider this final rule to be "economically significant"?
  • Did HHS consult with any external organizations, advocacy groups, or non-governmental entities in the drafting or finalization of this rule?

The letter to HHS is available here.

Issues:Health Care