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George Hill is president and CEO of Maine Family Planning.
Last month, the Biden-Harris Administration took a first step toward undoing the Domestic Gag Rule, which jeopardized access to affordable, high-quality family planning care for low-income people — including tens of thousands in Maine.
That’s great news. Maine Family Planning and other providers in other parts of the country continue to litigate the constitutionality of a federal rule that defies medical experts, requiring sexual and reproductive health professionals funded through the Title X National Family Planning Program to give incomplete, confusing, and medically unethical information to pregnant patients. It also mandated medically unnecessary “physical separation” between abortion and family planning facilities, which would have cost a fortune to put in place while further stigmatizing a legal, common, and safe health care procedure. It put access to birth control, testing and treatment for sexually transmitted infections, and cancer screenings for low-income Mainers at risk.
Bottom line, the Domestic Gag Rule politicized basic forms of health care and made it harder for patients already struggling to make ends meet to access the services they need.
A few weeks ago, the new administration began the process of undoing the Domestic Gag Rule and restoring the nation’s fractured family planning network with a presidential memorandum ordering the Department of Health and Human Services to review the rule with a possible aim of rescinding it. This is a step in the right direction, but we can’t celebrate yet
An executive order signed by former President Donald Trump can be reversed by an executive order by his successor, President Joe Biden. However, a rule, like Trump’s Gag Rule can only be disposed of by revising or eliminating it through the implementation of a new rule that supersedes the old one. This could take months, and only at that time will longstanding former grantees like Maine Family Planning be able to apply for reentry into the program.
And even when the Domestic Gag Rule is officially off the books, family planning providers in Maine will still be without this critical source of funding.
Six states are now entirely without Title X-funded providers, including Washington, Oregon, Illinois, Utah, Vermont and Maine. Several of those states have replaced the federal Title X funds they lost with state funds. Maine has not. A bill in the Maine State Legislature during the last session would have done so but it was stopped in its tracks when the pandemic hit. As such, our statewide family planning network, which encompasses 50 high-quality health care centers and serves over 28,000 Mainers every year, is relying on a combination of state funds, reserves and fundraising to maintain the high level of affordable care our patients deserve.
This would be challenging under any circumstances; during a pandemic, it is unsustainable. In time, private funds will gravitate to other needs; reserves, once spent, cannot be replaced.
The Biden-Harris Administration must move swiftly to make federal Title X funding available to states like Maine at the same time that it goes through the process of undoing rule changes imposed by the former administration. Otherwise, clinics may close and patients will go unserved. Especially during the ongoing COVID-19 pandemic, as people report increased need for affordable and accessible family planning care, the services we provide are more essential than ever.
Furthermore, Congress should take every opportunity to pump more resources into Title X, which for 50 years has empowered people to plan their families and build healthy futures, no matter how much money they make. To that end, we urge Maine Sens. Susan Collins and Angus King to protect the $50 million in supplemental funds for Title X included in the US House version of the American Rescue Plan Act of 2021.
There is something immediate, intoxicating, and even inspiring in a phrase like, “with the stroke of a pen,” especially when it comes to disposing of Trump- era policies. Unfortunately, it will take more than Biden’s Jan. 28 memorandum to make it right and undo the Gag Rule’s damage.
Maine’s situation is unique, it is urgent, and it requires prompt federal action to assure that sexual and reproductive health services continue to be accessible to all Mainers.