Tina was a hair stylist that cut my hair every five weeks when I lived in California. A divorced mother of two teenagers, she was a member of the working poor and made enough to disqualify her from participating in Medicaid. Her children’s health insurance was provided by their father’s employee insurance program, but the only insurance she had was to try and make sure she stayed healthy.
Tina was like so many others in the personal service industry: hairdressers, manicurists, housekeepers, care-givers, and physical trainers, all of whom had no employer-provided benefits and had to rely on a medical system ill-prepared to care for them.
Every year without fail, Tina made an appointment with the doctors at Planned Parenthood for her annual gynecological exam, including a Pap smear, breast exam, STD testing, and birth control. She had neither the desire, nor the income, for another child.
California participated in the expanded Medicaid program with the introduction of the Affordable Care Act, but Tina continued to see the staff at Planned Parenthood, with whom she had established a relationship and history. Only now, Medicaid would pick up the tab, allowing other women who did not qualify for Medicaid to get help under the Title X grant that enabled Planned Parenthood to continue to provide reproductive health care to all who needed it.
If the ruling of the federal judge in Texas that the ACA is unconstitutional is upheld by the higher court, 21 million Americans could be without health insurance, including 12 million Medicaid recipients. Tina would be one of them. Without the protections provided by the ACA, she would once again have to rely on Planned Parenthood for her reproductive healthcare.
But only if Planned Parenthood still provides services under Title X.
Title X was passed in 1970, during the Nixon administration, when bipartisanship was not just a memory. According to his signing statement, here’s what Nixon said of the bill that passed unanimously in the Senate and on a 298-32 vote in the House:
At the same time, I called for a national commitment to provide adequate family planning services within the next 5 years to all those who want them but cannot afford them. It was clear that the domestic family planning services supported by the Federal Government were not adequate to provide information and services to all who want them on a voluntary basis.
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The bill before me today, the "Family Planning Services and Population Research Act of 1970," completes the legislation I requested in my message on population. This measure provides for expanded research, training of manpower, and increased family planning services. In addition, it provides for the development of family planning and population growth information and education.
Six years later, in spite of President Nixon’s commitment to provide all American women with family planning services, Henry Hyde, the adulterer and future prosecutor in President Clinton’s impeachment trial, decided that poor women should not be allowed to have access to the full range of reproductive health services, and so introduced the Hyde Amendment. Under the Hyde Amendment, which has been successfully renewed every year since 1976, not one dollar of federal funding is allowed to be spent on abortions (with very few exceptions). After its adoption, abortions funded by Medicaid dropped from 300,000 to a few thousand. This amendment, by the way, not only impacts poor women who receive Medicaid benefits, but has led to other restrictions:
Federal restrictions on public funding for abortion affect women other than those who receive Medicaid. By the early 1980s, Congress had added restrictions similar to the Hyde Amendment to other federal programs on which an estimated 50 million people rely for their health care or insurance. In addition to low-income women on Medicaid, Native American women, federal employees and their dependents, Peace Corps volunteers, low-income residents of Washington, D.C., military personnel and their dependents, and federal prisoners have all been denied abortion coverage in their health care.
The Hyde Amendment already applies to any recipient of a Title X grant. No federal money can be spent on abortions because only a middle-class or wealthy woman should be allowed the privilege of deciding whether or not to carry a fetus within her body. The Hyde Amendment in and of itself is insulting, demeaning, and should not ever be renewed. But it will be., just as long as we keep electing forced-birther Republicans to federal office.
The latest attack by the Trump Administration in its ongoing war on women is two-fold. Under new restrictions announced earlier this year, clinics that receive funding and provide unfunded abortions must physically separate the abortion side of their services from all others. It is estimated that this will cost each clinic that provides both services between $20,000 and $40,000. Since these clinics tend to be funded through Title X and Medicaid, this is a financial burden that most will not be able to assume. Which is the point of the regulation: to drive abortion providers out of business.
A gag rule under the Trump Administration’s new regulation means clinics that receive Title X grants will not be allowed to refer a woman for an abortion. So once again, advocates of smaller government are the same ones who insist that the federal government can make better medical decisions for a woman than her doctor can. Hence, the federal government will tell a doctor what she can and cannot say to her patient. According to Physicians for Reproductive Health:
First is the Gag Rule which prohibits health care providers serving in Title X funded institutions from referring patients for abortion care. This is a clear violation of medical ethics and flies in the face of all health care providers and their value of the patient-provider relationship. No health care provider should be forced to withhold medical information from their patients.
Planned Parenthood, which provides 40% of the Title X clinics, has just said no.
Willing to forgo the estimated $60 million that Title X has provided the organization, about 12 percent of the funding it receives from Medicaid, Planned Parenthood will not participate in the Title X grant program. What this means for poor women is frightening when you bear in mind that in some areas, like the state of Utah, Planned Parenthood may be the only provider of Title X services. It is unlikely that other medical providers will be able to pick up the slack.
Women will go without care. They will not get cancer screenings. They will spread STDs. They will become pregnant. The only thing the forced-birthers are interested in is the last. They don’t care about the greater harm they are doing to poor women: their only interest is in controlling their reproduction.
Planned Parenthood has indicated that it has emergency funding that will allow it to continue to provide the medical services on a sliding scale, as it has done under Title X in the past, but no one is saying what will happen when that funding dries up.
This latest regulation is just one more step in making ours a religious-right society, bound by rules very similar to sharia law that used to be the boogeyman of the far right. Of course, now that they have their man in the White House all of that is different, and we are not supposed to notice. They are now planning on applying for the funding that Planned Parenthood will not receive to support religiously mandated family planning. That’s also known as the rhythm method, or chance.
When Shell offered its staff overtime pay to attend a Trump speech, the disturbing thought crossed my mind that perhaps Shell was not doing that to show its support for Trump but rather because it feared crossing him. We have seen how he has used the executive branch to punish his enemies and reward his cronies.
Congratulations to Planned Parenthood for finally standing up to this bully and saying: Enough.
These attacks on Planned Parenthood don’t exist in a vacuum. The people in this administration have spent years deliberately executing cruel, xenophobic, racist, classist, bigoted attacks. Attacks meant to hold down people, who are simply trying to access birth control that they can afford, and communities that have faced discrimination, systemic barriers, and so much more in so many parts of their lives. “They tried to bury us. They didn’t know that we were seeds.”
We have a chance at stopping this gag rule. According to Planned Parenthood, Congress will take up a bill in September that could stop it in its tracks. If you want to help, Planned Parenthood has information on how at the above link.