Advocates Say That Possible Title X Changes Are A Threat To Mainers’ Health

Jul 18, 2018

A coalition of patients, providers and advocates rallied in Augusta Tuesday to publicly release a letter to the Trump administration, opposing what they call a proposed 'gag rule' on the Title X program.

Title X distributes federal funds for reproductive health care services for low income patients. The proposed rule would restrict providers from referring patients to abortion services and, opponents say, make other changes that would gut a program that serves 22,000 Maine patients.

For decades, reproductive health providers in Maine have received Title X funds to provide services to low income patients such as family planning, treatment for sexually transmitted infections and breast and cervical cancer screenings. Title X funds are not allowed to be used for abortions, but under current rules, providers are required to include abortion when discussing a pregnant woman's range of options. The proposed rule would eliminate that requirement, and instead prohibit providers from discussing abortion.

"This is a political assault on the medical needs of women that will make it harder for everyday-Mainers to access health care,” says George Hill, president of Maine Family Planning.
Credit Patty Wight / Maine Public

"This is a political assault on the medical needs of women that will make it harder for everyday-Mainers to access health care,” says George Hill, president of Maine Family Planning.

Maine Family Planning distributes the $2 million that Maine receives every year from Title X to dozens of clinics. The proposed rule on abortion referrals does allow for an exception: if a pregnant woman clearly states she wants an abortion, a doctor may make a referral.

But nurse practitioner Stephanie Small of Planned Parenthood of Northern New England says it must include a mix of providers, “some of whom provide abortion, and some of whom don't. And I can't tell her which ones are which. Imagine being told you have cancer, receiving a list of providers, not all of whom provide treatment for cancer."

The proposed rule would also require clinics to separate abortion services from Title X services both financially and physically. In effect, opponents say, that's a ban on funding for organizations that offer abortions in addition to other health care.

"If the gag rule is implemented as written, it could cause Maine clinics to shut down,” says Sherry Huber.

Huber helped create Maine Family Planning nearly 50 years ago.
Credit Patty Wight / Maine Public

Huber helped create Maine Family Planning nearly 50 years ago. She says the proposed rule's changes extend to other health care services, eliminating, for example, the requirement that clinics offer a full range of contraceptive methods. Huber says that's a step backwards from decades of progress on teen pregnancy rates, which are at historic lows nationwide.

"Maine once had one of the highest teen pregnancy rates in the country, we now have the sixth lowest in the nation,” says Huber.

Jodi Bolduc, of Livermore, credits Maine Family Planning with helping her avoid teen pregnancy. She says she was raised in a rural town by a family of limited means, and it was a Maine Family Planning clinic that provided her with birth control and confidential health care.

"Had I not had access to Maine Family Planning, it is incredibly unlikely that I would stand before you today a healthy, confident, successful business owner in my 30s,” Bolduc says. “The resources provided by Maine Family Planning allowed me the freedom to start a family at the time of my own choosing, and provided me with the education and tools to remain healthy."

The health of 22,000 Mainers is threatened by the proposed changes to Title X, according to nearly two dozen Maine health and advocacy organizations. They've sent a letter to the Trump administration as part of the public comment period, which ends on July 31st.

This story was originally published July 17, 2018 at 5:25 p.m. ET.