New rules proposed Wednesday would largely return the Title X program to its pre-Trump formation, allowing more abortion clinics to participate in a program that provides free or subsidized contraception and other health services to about 4 million low-income Americans each year.
The move stems from a pledge President Joe Biden made as a candidate, followed by an executive order he signed shortly after taking office directing HHS to review the Trump administration's Title X rule. At the time, he pledged to "reverse my predecessor's attack on women's health access" and "undo the damage that Trump has done."
Trump's changes to the program, which took effect in 2019, barred family planning dollars to abortion providers and those who referred patients for the procedure. Democrats and abortion rights groups said the policy amounted to a "gag rule," while anti-abortion groups aligned with the previous administration said federal funding should never go to abortion providers, though longstanding rules already bar federal funding for abortion except in rare cases.
The Trump policy also required clinics that provided abortions as well as Title X services like STD tests and contraception to create two physically separate facilities, a provision many participants said was so burdensome they had to exit the program.
In the rule released Wednesday, the Biden administration said approximately a quarter of the program's providers left due to the restrictions, leaving the program with 1,000 fewer service sites and 22 percent fewer patients served nationwide. Six states lost all of their Title X providers, while another six lost the vast majority, according to the health department, which estimated the changes led to as many as 181,477 unintended pregnancies.