While other Planned Parenthood clinics in the country may soon feel the pinch from the organization's decision to withdraw from the federal family planning Title X program, the CEO of Planned Parenthood Maryland said the Old Line State has relatively little to fear.
On Aug. 19, Planned Parenthood officially announced its decision to withdraw from Title X, thus rejecting the funding they had received since the program's inception. The withdrawal came about as a result of the Trump administration's decision to alter the program to include rules the organization argued would prevent patients of theirs from receiving necessary information and services.
The U.S. Department of Health and Human Services website says that the new iteration of the rules "prohibits the use of Title X funds to perform, promote, refer for, or support abortion as a method of family planning."
The altered rules also include a stipulation that for participating organizations, there must be a "clear financial and physical separation between Title X and non-Title X activities" in order for them to continue receiving funding. While abortion referrals are prohibited under the new laws, patients may still receive "nondirective pregnancy counseling, including on abortion."
When the decision was announced last month, acting Planned Parenthood Federation of America president Alexis McGill Johnson said the organization was effectively "forced" out of Title X participation. Nationally, the program administers $286 million annually. The Washington Post reported the decision to withdraw would cost the organization about $60 million.
The "sole federal program" of its kind, approximately 4 million people annually rely on Title X-funded services, wrote Planned Parenthood of Maryland president and CEO Karen Nelson in an email to APG Media of Chesapeake. About one-third identify as people of color, Nelson wrote, and about 1 in 10 have limited proficiency in English. Further, she said, 6 in 10 women who obtain care through Title X-funded providers consider it their sole source of care.
Though the decision to withdraw is expected to strongly affect clinics nationally, Nelson wrote that Maryland's Planned Parenthood clinics are spared from much of the fallout by the sole virtue of being located in Maryland. Maryland, Nelson noted, was the first state to mandate contraceptive coverage, and in April this year the General Assembly voted to reject federal funding for state clinics that otherwise would have participated in Title X. They instead opted to fund these programs with state funds.
Nelson credited the "foresight" of the General Assembly with keeping health care that extends beyond just abortions available to Maryland residents. In 2017, Nelson wrote in the email, more than 73,000 residents received care ranging from screening for sexually-transmitted infections and illnesses spanning the gamut from breast cancer to high blood pressure, to pelvic exams and more at Planned Parenthood clinics and others.
"Most of the country, however, is not so lucky," Nelson wrote in her emailed statements. "More than 1.5 million people could be affected, including adolescents, those without insurance and a disproportionate number of people of color. Everyone deserves affordable, quality sexual and reproductive health care from the provider of their choice, regardless of their economic or insurance status, or their state of residency."
Nelson wrote that Maryland's history of protecting family planning and abortion through state law spans back decades, starting with the General Assembly codifying the Roe v. Wade decision in 1991. The legislature ruled to have birth control covered by insurance in 1998, she said, and was the first state to do so. They voted in 2017 to fund family planning services directly should the so-called "gag rule" on referring patients to abortion providers be implemented, and followed through this year, she said.
"Maryland is an example of what can happen when the public and the policymakers support Planned Parenthood and encourage Planned Parenthood clinics to not only survive but thrive," Nelson wrote. "However, as good as we are today we can always be better. Health outcomes can and must be improved. There is more to do to reduce barriers to health care and expand access to birth control, but here in Maryland we should be proud that our elected officials consistently support policy that keeps high quality reproductive care affordable and accessible for everyone."
Some pro-life opponents of Planned Parenthood contend the organization's concerns about patients losing access to necessary health care services are misplaced. Ali Rak, president of Charles County Right to Life, wrote in an email to APG Media of Chesapeake that the Planned Parenthood clinic in Waldorf and the Charles County Health Department both offer the same health care services, including family planning.
"They have a robust donor base and could provide those services on a sliding scale just as any other private health care organization has the prerogative to do," Rak wrote of Planned Parenthood. "The funding is not disappearing, but rather will be redirected to non-abortion referring organizations such as Federally Qualified Health Centers or the local health department."
In choosing not to veto the legislation that will allow Planned Parenthood to receive state funding to continue to provide abortion access to its patients, Rak wrote that Gov. Larry Hogan (R) "betrayed a huge swath of his constituency ... even after the thousands of calls from Maryland citizens and multiple resolutions from his own party calling on him to do so."
"Maryland Right to Life's Director of Legislation, Laura Bogley, worked tirelessly to shield the Maryland tax payers from continuing to replace funding for an organization positively bathing in controversy," Rak wrote. "While the abortion lobby continues to enjoy the protection and favor of the Maryland General Assembly, we fight harder to expose the ugly realities of abortion and the giants who protect it at all costs like Planned Parenthood. And those realities are that abortion kills children and harms women."