A fortnight ago, the Department of Health & Human Services (HHS) quietly published a proposed rule to regulate how states can spend federal family planning funds. This money, Title X funding, is issued to states, and county health departments then decide which subgrantees receive the money.
However, two weeks ago, HHS intervened to say they couldn’t.
When HHS distributes Title X funds to the states, the county health departments get to decide which subgrantees get the money. In some instances, the counties decide to give the funding to community health centers and county health departments. In short, some states opt for family planning service providers that don’t perform abortions.
Because of a law that prohibits federal money from being used for abortion (the Hyde amendment), Title X funds that go to abortion clinics can’t be used directly for abortions anyway. However, giving the funding to these clinics frees up more of their money for abortion. For this reason, in Tennessee (to give one example), counties simply made the decision to give their Title X funds to community health centers (who are fully able to provide family planning services), and not to abortion providers like Planned Parenthood.
HHS issued a rule two weeks ago that states were no longer allowed to do that. Under the proposed guidance, states will not be allowed to avoid giving title X funding to entities that perform abortions, like Planned Parenthood.
This is a major problem. HHS issued a rule that vastly shifts current federal policy; this runs counter to decades of consensus that it is the job of Congress to debate and legislate such issues, not unaccountable bureaucrats. As a legislative body, Congress is composed of representatives who are elected by the American people. We come to Washington every week to work on their behalf. Oversight of the government agencies when it comes to health issues is our job, especially mine, as Chairman of the Health Subcommittee of Energy & Commerce.
Secondly, there is a reason that Title X funding is distributed so that counties have the last say. We’ve seen with disasters like Obamacare that a top down approach applied to every type of American simply doesn’t work. Therefore, the closer decision making occurs to local political bodies, the better. County health departments are better equipped to decide what fits the needs of their counties, rather than the federal government issuing a one-size-fits-all approach where the same formula for Manhattan, New York is prescribed for Lancaster, Pennsylvania. The characteristics of the American population vary widely from state to state and county to county. The more tailored policy can be to fit a certain locality, the better; HHS’s rule totally ignores this proven truth.
Thirdly: those opposed to abortion take serious issue with this mandate, and rightfully so. As I mentioned, because of the Hyde Amendment, no federal funding is allowed to go to abortions. However, as I’ve mentioned in past columns, when an abortion clinic is given federal funding for other services (like the provision of contraception or female health checkups), it increases its bottom line where more of the clinic’s money is freed up for abortion. Additionally, it’s worth noting that part of the Democratic platform this year is an all-out effort to repeal the Hyde Amendment, the last barrier to government provided abortion. It’s interesting that HHS has chosen an election year to push to subvert states’ abilities to move family planning funds away from abortion providers like Planned Parenthood.
HHS argues that withholding Title X funding from abortion providers could cause a disruption in services in areas where abortion clinics are most prolific.
But, there are many ways to ensure that the use of Title X funds are distributed without interruption that don’t include forcing states to dole them out to abortion providers. One of them would be to encourage states to document that each part of the population has access to a clinic that provides family planning, as a requirement for receipt of Title X funds.
HHS also argues the proposed rule is not a burden on states as long as the state doesn’t have a law directly contradicting it (which some obviously do, otherwise HHS wouldn’t have had the need to propose the sweeping rule in the first place). Additionally, HHS notes that if states don’t want to meet the new requirement, they can halt Title X funding at any time. If HHS’s goal is to refrain from a disruption of family planning services, suggesting that a state opt out of Title X funding completely would seemingly be the last thing the agency would want. Such a decision would create a permanent disruption instead of the theoretical temporary ones HHS seeks to avoid.
Given another fortnight, HHS could deliver a much more sensible rule if it receives enough feedback. You can weigh in online at bit.ly/HHSabortionmandate . The comment period closes on October 7, 2016.
Congressman Joe Pitts serves the people of Pennsylvania’s 16th congressional district.