The Biden administration released a proposed rule on Wednesday that would reinstate eligibility for federal family planning funds to organizations that provide abortions or abortion referrals, a move that would directly affect groups like Planned Parenthood.
Under current law, providers cannot use federal funds for abortions except in rare circumstances.
The proposed rule would allow Title X, the nation’s federal family planning grant program, to reinstate eligibility for grants to organizations that provide abortions or abortion referrals, if they use only private funds for abortion while using grant money for other family planning activities such as providing birth control.
It also proposes to reverse a requirement that prevents Title X grantees from sharing a physical space with an abortion provider.
The rule says the changes under the Trump administration may have led to up to 181,477 unintended pregnancies.
The proposed rule is expected to be the first of several to reverse changes or expand access to health care for women as well as LGBTQ individuals.
The Trump administration finalized its rule in 2019, which blocked groups like Planned Parenthood from the Title X program unless they stopped performing abortions.
Funding for the Title X program as a whole did not decrease due to the Trump administration rule, but was redistributed to organizations that did not support abortion access.
Prior to the Trump rule, Planned Parenthood reported that it served about 40 percent of Title X patients. That rule also led six states — Hawaii, Maine, Oregon, Utah, Vermont and Washington — to withdraw from the Title X network entirely.
The Biden administration's proposed rule says that changes to clinic eligibility have decreased the number of grantees and led to fewer clients served.
"Overall, the Title X program lost more than 1,000 service sites. Those service sites represented approximately one quarter of all Title X-funded sites in 2019,” the new rule reads.
In New York, the number of Title X-funded service sites dropped from 174 to just two, leaving more than 328,000 patients without Title X-funded care, the rule says.
The proposal argues that the Office of Population Affairs has been unable to find new grantees in many states since the 2019 rule took effect.
The Trump administration rule became the subject of multiple lawsuits. The 9th U.S. Circuit Court of Appeals upheld the rule nationally, but the 4th U.S. Circuit Court of Appeals blocked the rule in Maryland, resulting in a circuit split.
The Supreme Court announced in February it would take up the case, but in March, the Biden administration and the challengers both asked for the case to be dismissed. Nineteen states filed a joint motion to defend the requirements in court.
The Trump regulation was similar to a Reagan-era rule, which was upheld under the Supreme Court case Rust v. Sullivan, where the court ruled that it was legal for the government to "fund one activity to the exclusion of another.”
It’s likely the Biden rule will also be challenged in court.
Planned Parenthood Federation of America President and CEO Alexis McGill Johnson said in an interview Wednesday that the group appreciated the change and hoped to work to modernize the Title X program.
She called it "the next step in a process to restore access, and it is obviously creating the opportunity to both address the harm that has decimated access to things like birth control and STI testing," referring to sexually transmitted infections.
The Centers for Disease Control and Prevention on Tuesday issued new data that STI rates had reached an all-time high for the sixth consecutive year.
Johnson said Planned Parenthood plans to mobilize its supporters to submit comments to the administration during the comment period to "make sure that the administration really understands the harms that have been created so that we can help quickly end this discriminatory policy and create a pathway for providers who were forced out of the program."
Anti-abortion groups expressed concerns that the rule could be used to direct millions of dollars to groups like Planned Parenthood.
"The newly proposed Title X rules fail to recognize that abortion has never been an accepted method of family planning. They would undo the progress that has been made towards disentangling American tax dollars from funding the abortion industry," said Grazie Pozo Christie, a policy adviser for The Catholic Association.