No More Referrals for Abortion?

President Bush is considering a gag rule that would prevent federally funded clinics from discussing abortion.

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Corrected on 5/28/08: An earlier version of this post incorrectly stated that clinics that accept Title X funds cannot provide abortions. They can, but they cannot use federal funds for the procedures.

Something may be up with the government's Title X program, according to the women's health advocates who've been calling me up lately.

For those of you who aren't policy wonks, Title X provides $280 million every year in federal funds to subsidize reproductive healthcare for low-income folks. In 2006, these funds provided 2.5 million Pap smears, 2.4 million breast exams, 5.2 million tests for sexually transmitted diseases, and 650,000 HIV tests at clinics like Planned Parenthood. When a woman is pregnant, Title X funds provide prenatal care—including a sit-down with a doctor to discuss various options: Keep the baby? Give the baby up for adoption? Have an abortion? Clinics can't use Title X funds to provide abortions; they must use separate funds for these services.

Now antiabortion groups are calling on President Bush to change Title X so that doctors must stop even discussing abortion as an option. In a letter to Bush, one group, the Family Research Council, wrote that "Title X funds continue to be used by abortion providers such as Planned Parenthood to promote abortion." This isn't true, Planned Parenthood spokesperson Tait Sye tells me. He adds that putting a gag rule into effect could cause some clinics to stop accepting federal funds, in essence cutting health services for women. Some contend this has already happened in foreign clinics that accept U.S. funds. An overseas gag rule implemented by President Ronald Reagan in 1984 prohibits U.S.-funded foreign clinics from telling women where they can get safe legal abortions. According to the International Women's Health Coalition, "The funding ban forces clinics that offer women access to contraceptives and vital health services—often the only existing clinics in underserved areas of countries with weak public health systems—to cut back their services or even, in some cases, to close." (Reagan also implemented the gag rule on Title X-funded clinics in this country, but Bill Clinton overturned it when he became president.)

So, let's say Title X is changed. I'm wondering how exactly a gag rule would be implemented. What if a woman asked for an abortion referral? I ask Sye. Would the doctor press her to contact an adoption agency instead? Sye says he doesn't know since no specific rule change has actually been proposed by the Department of Health and Human Services. The HHS press office declined to return my phone call, but word is that it might issue a new rule—which doesn't need to be approved by Congress—by Sunday. Republicans in Congress are also weighing in: Twelve of them sent a letter to Bush last week asking him not to change Title X, while others are strongly in favor of the change.

You, too, can weigh in by E-mailing a letter to Bush. If you're against the gag rule, you can fill out a letter by the National Family Planning and Reproductive Health Association. If you're in favor, you can fill out the Family Research Council's letter. And answer our poll below.

Survey: What Is Your Opinion?

Should doctors who work at federally-funded clinics be prohibited from discussing abortion with pregnant patients?

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