Planned Parenthood opts out of U.S. subsidies in fight over abortion referrals

By Brendan O'Brien

(Reuters) - Planned Parenthood said on Monday it was withdrawing from a federal programme subsidizing reproductive healthcare for low-income women after the Trump administration banned participants in the programme from referring women to abortion providers.

Planned Parenthood, the largest abortion provider in the United States, said its move was spurred by a federal appeals court decision last month clearing the administration's way to restrict Title X grants under a new policy critics have branded a "gag rule."

In addition to barring recipients from making abortion referrals, the policy requires financial and physical separation between facilities funded by Title X and those where actual abortions are performed.

The rule, imposed by the Department of Health and Human Services (HHS), is part of a broad effort by the Republican president, his allies in Congress and numerous Republican-dominated state legislatures to curtail abortion access in recent years.

Planned Parenthood, accounting for about one-fifth of all Title X funds granted, had vowed to cease accepting money from the programme months ago, when HHS said it would start enforcing the new restrictions. The group said it would rely instead on private donations and emergency funds to make up the difference as best it could.

Monday's move marked a formal Title X withdrawal, to remain permanent unless Congress acts to overturn the restriction or legal challenges prevail in court.

"Due to an unethical and dangerous gag rule, the Trump administration has forced Planned Parenthood grantees out of Title 10," Alexis McGill, acting president and CEO of Planned Parenthood, told journalists on a conference call.

STATES FOLLOWING SUIT

Planned Parenthood is not alone. Legislatures in Maryland and Massachusetts preemptively adopted measures to opt out of Title X and provide state funding in its place if the new rule took effect. And governors of five other states - Hawaii, Illinois, New York, Oregon and Washington - have said they would do the same. So has Maine Family Planning, a nonprofit, sole recipient of Title X funds in that state.

Congress appropriated $286 million in Title X grants in 2017 to Planned Parenthood and other health centres to provide birth control, disease screening and other reproductive health and counselling services to poor women.

That funding already was prohibited from being used to pay for abortions, but abortion opponents have long complained that the money in effect subsidized Planned Parenthood as a whole, including its abortion services.

The organisation had been providing healthcare to about 40% of the 4 million people who rely on Title X funding annually, with 600 of its clinics receiving money from the programme.

Critics said Planned Parenthood's action showed it was primarily focussed on abortion.

"In withdrawing from Title X, Planned Parenthood has made it crystal clear that abortion is its number one priority," said Ashley McGuire, a senior fellow with the Catholic Association.

Abortion has remained one of the most contentious issues in U.S. politics since the U.S. Supreme Court's landmark 1973 Roe v. Wade decision affirming a woman's constitutional right to terminate her pregnancy.

Opponents cite religious beliefs in decrying abortion as immoral, while the other side casts abortion restrictions as infringing on women's private medical choices and control over their own bodies.

Federal judges in Washington state, California and Oregon, among nearly two dozen states challenging the administration's rule in court, issued preliminary injunctions against its enforcement earlier this year.

But the 9th U.S. Circuit Court of Appeals on June 20 lifted those injunctions, and the same court rejected emergency bids to overturn that decision in July. That allowed the restrictions to take effect while court cases proceed.

The rule largely restored a restriction created in 1988 and upheld by the U.S. Supreme Court in 1991, only to be suspended by the Clinton administration in 1993.

(Reporting by Brendan O'Brien in Chicago; Additional reporting by Steve Gorman in Los Angeles; Editing by Matthew Lewis)