Lawmakers challenge legality of Trump’s ‘domestic gag rule’

WASHINGTON, D.C. – A trio of Democratic leaders serving on the House Energy and Commerce Committee, which oversees the U.S. Department of Health and Human Services, sent a letter to HHS Secretary Alex Azar late Thursday demanding evidence to justify changes the Trump administration recently made to the federal government's Title X family-planning program.

In the letter, signed by U.S. Reps. Diana DeGette (D-CO), Frank Pallone, Jr. (D-NJ) and Anna G. Eshoo (D-CA), the lawmakers raised concerns that the newly finalized rule does not comply with the statutory requirements of Title X. Specifically, that the new rule undermines Congressional intent for the program by reducing – instead of increasing – access to healthcare. Also, because it would interfere with doctor-patient relationships by forcing providers to choose between providing comprehensive care or receiving funding under the Title X program.

"We have serious concerns regarding the final rule's compliance with the Title X statute, the public health implications of this action, and the Administration's rationale for these changes," the lawmakers wrote. "Additionally, we have questions about the Department's expansive claim of authority under this rule, HHS's failure to account for the significant costs created as a result of the final rule, and the internal regulatory process used by the Department to review and finalize this rule."

The Title X program provides grants to health service organizations to provide family-planning and other health services to low-income women and families. On Friday, the Trump administration announced that it had finalized new changes to the program to bar any organization that provides abortion services, or refers a patient to receive such services elsewhere, from receiving any future funding through the program.

The move was widely seen as a direct attempt to defund programs, such as Planned Parenthood, which receives tens of millions of dollars every year through the program. In a statement released immediately after the rule was finalized, DeGette, who also co-chairs the Congressional Pro-Choice Caucus, blasted the administration for issuing what she said amounts to a "gag rule" that will do "irreparable harm to millions of women and families across the country by limiting their access to safe, comprehensive reproductive health services."

Nearly four million women a year turn to Title X funded clinics for various health care needs. In their letter to Azar, the lawmakers called the administration's actions to undermine the successful program "disturbing."

"The success of Title X is largely due to the network of qualified family planning providers that have implemented the program's goals since its creation," the lawmakers wrote. "It is disturbing that the Administration has chosen to undermine the ongoing success of this program by finalizing this rule."

Specifically, the lawmakers are demanding Azar provide answers to the following questions:

• Does HHS have evidence to justify the physical separation requirements included in the Title X rule?
• What evidence did HHS rely on in making an exception to include adoption as a postconception care Title X service, but not the other options previously covered under the statute?
• Why did HHS not take into account the economic impact on Title X patients, such as the lack of access to previously available health care services, which public health experts have said could result from the final rule?
• Given that this rule clearly adversely affects public health, why did the Administration not choose to consider this final rule to be "economically significant"?
• Did HHS consult with any external organizations, advocacy groups, or non-governmental entities in the drafting or finalization of this rule?