1. Potera, Carol


Maryland is the first state to fund its own Title X program.


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On March 4, the U.S. Department of Health and Human Services (HHS) issued a new rule for the Title X family planning program that blocks funding for clinics that support or provide referrals for abortion. Established in 1970, Title X is the only federal program dedicated to family planning and serves 4 million mostly low-income people annually. On April 25, however, a federal judge issued an injunction temporarily preventing the imposition of this rule. It was not immediately clear whether the HHS would appeal.

Figure. Senator Ed M... - Click to enlarge in new window Senator Ed Markey (D-MA), with Planned Parenthood League of Massachusetts medical director Danielle Roncari (right), speaks out against the Trump administration's rule that would withhold Title X funding from health clinics that provide or refer abortion services. Photo by Chris Lisinski / State House News Service.

Nearly three-quarters (73%) of Americans oppose the nationwide gag rule, according to a nationwide poll commissioned last year by Planned Parenthood; the rule eliminates Title X's long-standing requirement that all pregnant patients be offered nondirective counseling on pregnancy options, including information about parenting, adoption, and abortion. In a February 27 policy analysis, the Guttmacher Institute said the gag rule flouts medical ethics and is "blatantly coercive."


Seventeen national medical professional organizations, including the American Nurses Association, American College of Nurse Midwives, American College of Physicians, and American College of Obstetrics and Gynecologists, joined in a statement of opposition, saying the regulation "disregards the expertise of the medical and scientific community and evidence-based standards and will do indelible harm to the health of Americans and to the relationship between patients and their providers." The statement continued: "Family planning policy should be driven by facts, evidence, and necessity, not politics and ideology."


Also opposed are more than 110 health advocacy groups. In a letter to HHS Secretary Alex Azar, they noted that Title X clinics provide basic preventive health care, including "cancer screenings, birth control, sexually transmitted infection screenings, pregnancy testing, and well-woman exams." Planned parenthood clinics serve 41% of the people who get care through Title X; Title X funds cannot be used to fund abortion services.


Maryland is the first state to defy the gag rule by refusing federal Title X money; in 2017 it passed a bill authorizing state funds for Title X providers who refer and/or provide abortion. Then, in March, following HHS's announcement of the new rules, the legislature voted to reject all Title X funds "because the new rules remove the requirement that the program fund evidence-based family planning services," Mary Kay DeMarco, president of the Maryland Nurses Association, said in a statement. "As nurses, we have the ethical responsibility to ensure that patients are provided with evidence-based care, whether it is family planning or any other type of health care services."-Carol Potera