In October, the Biden administration reversed a domestic gag rule implemented by the Trump administration in 2019 surrounding Title X, the only federal grant program that offers people comprehensive family planning and preventive health services.
Yamelsie Rodríguez, the president and CEO of Planned Parenthood Missouri, explains, “This program was founded during the Nixon administration with the purpose of providing additional services and support primarily for people with low incomes, and that specifically addresses the needs of the Black, Latino, [and] Indigenous populations with a particular center also on young people.”
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The family planning services grantees qualify for include discussion regarding reproductive life plans, services for delaying and preventing pregnancy, pregnancy testing, counseling, and services to aid with preconception health and becoming pregnant (infertility services; STI education, screening, and treatment; HIV testing; substance use disorder screening and referral).
The gag rule prohibited clinics offering abortion care or referrals from recieving the federal funds associated with the Title X program. Rodríguez says, “The effect on the Title X program was devastating, specifically because Planned Parenthood across the country, and certainly here in Missouri, played a disproportionate role in serving those low-income patients.” Prior to the gag rule, 40 percent of patients enrolled in Title X did so through Planned Parenthood health centers nationwide.
In response to the gag rule, Planned Parenthood decided to leave the program, a choice the group carefully considered. Rodríguez explains, “We were committed to ensuring that our education and our counseling was non-biased and non-coercive. We were not going to withhold information about pregnancy options that was comprehensive and included everything from parenting to adoption [to] terminating the pregnancy.”
Since the Biden administration revoked the gag rule, Planned Parenthood was able to begin reentry into the Title X program at locations in the St. Louis region and in Southwest Missouri, though not all of the Missouri health centers have reentered yet. The centers in Joplin, Springfield, St. Louis at South Grand, and St. Louis in the Central West End have all reenrolled in the program.
Before its reentry, Planned Parenthood turned to grant funding for items like low-cost and free birth control, as well as philanthropy and donor support.
Rodríguez says, “We continue to keep our doors open, and we did not turn any patient away for their inability to pay…Funders and donors played a very generous and critical role in keeping services accessible. Title X will expand that access and our ability really to serve patients who face the most barriers in accessing health care now.”
For the health centers in the St. Louis metro area, Joplin, and Springfield that have enrolled back into the program, Title X opens up access to sexual and reproductive health care for a number of qualifying patients. “More people now will qualify for low cost or no cost services…It also means that young people under the age of 18 can once again access sexual and reproductive health care confidentially, as Title X requires adolescent confidentiality,” Rodríguez highlights.
Before moving forward with further expansion of Title X in additional Missouri locations, Planned Parenthood hopes to serve around 1,000 patients in the program before March of 2022. The health centers that reenrolled in November have already seen hundreds of patients that qualify for the program.
Rodríguez understands decisions like the one made by the Trump administration may happen again, saying, “Depending on which administration is in power there [is] either going to be a move towards increasing access to preventative care or a push back to restrict access to that care…I think it’s really important for all of us to continue to advocate and ensure that at the state level and at the federal level, we are ensuring that the policies reflect the need of the people.”
