After taking a turn speaking about the medical services she's received there, Amelia, who declined to give her last name, listens during a news conference at a Planned Parenthood clinic addressing a change in rules on the nearly 50-year-old Title X family planning program, Thursday, Aug. 22, 2019, in Seattle. Credit: Elaine Thompson | AP

As expected, Planned Parenthood and Maine Family Planning have dropped out of the federal family planning program, known as Title X, after the Trump administration changed the program’s rules to restrict what information medical providers can provide about abortion services.

Dropping out of Title X has cost the Maine groups a significant source of their funding, putting at risk a wide range of family planning services that are especially important to the state’s low-income residents.

“We cannot accept the Trump-Pence administration’s demand that we withhold information from our patients,” Nicole Clegg, vice president of public affairs at Planned Parenthood of Northern New England, said in a statement earlier this month. “Because of our commitment to ethical patient care, it is impossible for Planned Parenthood to continue participating in the Title X program with the gag rule.”

Together, the groups provide health care for more than 22,000 Mainers. Almost half of the patients who receive Title X services are at or below the federal poverty level.

Elsewhere in the country, patients are already having to pay much more for family planning services, such as birth control, and for health screenings, such as exams to detect breast and cervical cancer. Some clinics have already reduced their hours because of the new rules.

Maine Family Planning, which lost nearly a third of its funding, has turned to private donors and their reserves to maintain services. This likely isn’t sustainable in the long term.

This highlights the need for action in Congress to eliminate the so-called gag rule, which unnecessarily interferes with women’s ability to make their own family planning decisions, in consultation with medical professionals at clinics that participate in the Title X program.

The so-called gag rule makes it illegal for health care providers in the Title X program to refer patients for an abortion and limits what information can be shared about ending a pregnancy. Censoring these providers inhibits the patient-provider relationship and compromises medical ethics by prohibiting providers from providing patients information about all of their options.

The federal Department of Health and Human Services said it would begin enforcing this provision this summer.

The rule changes also requires “physical separation” between areas where abortions are provided and areas where other health care services are provided. This could require separate entrances and staff members, which could be cost prohibitive for some providers.

Federal law has long barred the use of federal funds to provide abortions. Title X provides funding for family planning such as contraception and treatment of sexually transmitted diseases and preventative treatment including screenings for breast and cervical cancer.

The U.S. House passed a health spending bill in June that included language to block the gag rule. It was supported by Maine Reps. Jared Golden and Chellie Pingree.

Sens. Susan Collins and Angus King are pushing the administration to reverse the rule changes. King joined 41 senators, all Democrats and independents, in sending a letter to Health and Human Services Secretary Alex Azar asking him to rescind the changes.

“Vital services — including cancer screenings, family planning, and other preventive healthcare — are being threatened as part of the Administration’s ongoing fixation with standing between a woman and her doctor,” King said in a July statement.

Collins and fellow Republican Sen. Lisa Murkowski sent their own letter to Azar last year asking him to reconsider the rule.

“The best way to reduce the number of abortions is to expand access to family planning services,” Collins said in a statement to the Bangor Daily News this week. “That’s why I have long been a strong supporter of Title X family planning, and why I have repeatedly opposed attempts to impose gag orders or burdensome requirements for separate facilities on both clinics in the United States and family planning programs supported by foreign aid.”

Lawsuits have been filed, including one by Maine Family Planning, to stop the new rules.

The Trump administration rule changes are not based on science, will harm women and waste money. Reversing the change is essential to protect a full range of family planning and medical services for all women.